Delayed diagnosis of transanal prolapse of an ileo-colic intussusception in a 10-month-old infant in rural Cameroon: a case report

Delayed diagnosis of transanal prolapse of an ileo-colic intussusception in a 10-month-old infant in rural Cameroon: a case report

Blog Article

Abstract Background Transanal protrusion of intussusception is a complication of intussusception which here involves the exteriorization of the apex of the intussusceptum through the anus.However, it is rarely reported and its confusion with rectal prolapse often leads to a diagnostic delay.Case presentation A 10-month-old female with no significant past history from a rural area in the Extreme North region of Cameroon was referred from a local health centre to our emergency deparment for an irreducible mass.It was reported that the child had spent 5 days at home on over-the-counter medication, then 3 days at a health centre where she was being treated for a respiratory tract infection and a rectal prolapse.

On arrival at our hospital, she was conscious and moderately dehydrated.Cardiopulmonary examination revealed generalized coarse crackles over both lung fields.Her abdomen was tender, with a left upper quadrant mass, absent bowel sounds and a dark anal mass.In view of these, diagnoses of bronchopneumonia, intestinal obstruction and a probable rectal prolapse were made.

An exploratory laparotomy was carried out after resuscitation with per-operative findings of a prolapsed ileo- colic intussusception and a necrosed intussusceptum.The necrosed portion was resected and an end-to-end ileo-transverse anastomosis was carried out.The immediate post- operative period was uneventful, but the patient died 3 days after the surgery, from an overwhelming sepsis.Conclusions Transanal protrusion of intussusception requires timely surgical intervention to 3 piece horse wall art prevent mortality.

The similarity in presentation to rectal prolapse coupled with inadequate knowledge on the condition by primary healthcare personnel causes a delay in the diagnosis and an increased mortality.A high index of suspicion is essential for an early diagnosis and an improved referral system for timely and definitive treatment.