Ileo Ileal Intussusception in a Preterm Neonate: A Letter to the Editor

Dear Editor, Intussusception is a condition wherein one segment of the intestine "telescopes" inside the adjacent segment, leading to intestinal obstruction. While it may frequently occur in infants and children, only 0.3% of cases occur in neonates.[1] This rarity contributes to frequent misdiagnosis, considerable delay in its management, and an increase in associated morbidity and mortality. The objective of this letter is to draw attention to the case of a neonate who was born prematurely at 32 weeks of gestation via an emergency C-section. At birth, he suffered from labored breathing, nasal bleeding, and abdominal distension with progressively increasing bile-stained nasogastric aspirates. An initial misdiagnosis of necrotizing enterocolitis led to a considerable delay in management. After an abdominal ultrasound revealed no sonographic evidence of obstruction [Figure 1], an emergency laparotomy was done, which allowed the diagnosis to be made. The neonate was discharged 2 weeks after a bowel resection and ileostomy procedure was performed.Figure 1: Ultrasound abdomen showing no evidence of intestinal obstructionIt is acknowledged that there are limitations in detecting ileo-ileal intussusception using imaging modalities like X-ray and ultrasound. In most cases, the diagnosis is made intraoperatively,[2] followed by surgical correction. Therefore, we would like to emphasize the importance of maintaining a strong level of clinical suspicion toward the condition when diagnosing neonatal intestinal obstruction to ensure timely management and prevent further complications. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.