Non-Hodgkin’s lymphoma as a cause of intussusception: a case report

Abstract

Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment. This condition is frequent in children and presents with the classic triad of cramping abdominal pain, bloody diarrhea and a palpable tender mass. Secondary intussusception is caused by organic lesions, such as Meckel’s diverticulum, benign and malignant lesions, metastatic neoplasms or sometimes iatrogenically. Surgery is the definitive treatment of secondary intussusception. Formal bowel resection with oncological principles is followed for every case where a malignancy is suspected. A ten-year-old female presented to the casualty with severe pain in abdomen associated with 1 episode of blood in stools diagnosed with intussusception. She was taken for emergency laparotomy, and no lead point was identified. She presented with recurrent intussusception and was taken for re-exploration, when a definitive approach was opted for, and she underwent a resection of the obstructed bowel at the ileo-caecal junction and an ileo-ascending anastomosis. On histopathology, the ileo-caecal junction showed a proliferative, circumferential mass which was confirmed to be a diffuse large B cell lymphoma. It is uncommon for pediatric intussusception to result from a neoplasm. It takes imaging modalities to make the diagnosis. Surgical intervention is required as soon as a suspicion is raised in order to avoid consequences such gut necrosis and ischemia.