IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 2 Ser. 4 (February. 2019), PP 59-61 www.iosrjournals.org DOI: 10.9790/0853-1802045961 www.iosrjournals.org 59 | Page Ileoileocolic Intussusception In A Child Due To Mesenteric Lymphadenitis: A Case Report Vidyanand Tripathi 1 Arshad Ahmad Ansari 2 G.Jeffrey Ashiq 3 , Abhik Sil 4 ,James Oscar Marak 5 , Resen Rajen S Methikkalam 6 , G S Moirangthem 7 . 1,2,3,4,5,6,7 (Department of general surgery, Regional Institute of Medical Sciences/Manipur University, India) Corresponding Author: Vidyanand Tripathi Abstract: Intussusception is second most common cause of acute abdomen in children, following appendicitis.It is seen most commonly in 5-10months of age. Most common cause of intussusception in children is idiopathic while in adults usually a lead point is seen. Ileoileocolic type of intussusception is seen only 12% found in population. Here we are presenting a case of ileoileocolic type of intussusception in child due to mesenteric lymphadenitis diagnosed intraoperatively. A male baby of 4month 15days presented with clinical features suggestive of intussusception and confirmed by ultrasound showing target sign. Patient underwent emergency laparotomy and intraoperatively ileoileocolic intussusception with multiple mesenteric lymphadenopathy was found, some part of ileum was gangrenous for which segmental resection of ileum with ileoileal anastomosis was done. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 26-01-2019 Date of acceptance: 09-02-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Intussusception is second most common cause of acute abdomen in children, following appendicitis 1- 3 .It is most commonly seen in the first 3 years, and peaks between the 3 rd and 9 th month. Sudden onset of vomiting, intermittent pain abdomen and rectal bleeding in the form of red currant jelly is the usual presentation 3-5 . More than 70% of intussusceptions can be reduced non operatively by resuscitation and air enema. Strangulated bowel and pathological lead point are unlikely to reduce by enema. Recurrent intussusceptions occurs in up to 5% of patients after non operative reduction. In children, more than 80% of intussusceptions are ileocolic. Here we present a case of ileo-ileocolic intussusception in a 5 month old infant due to mesenteric lympadenitis 6 . II. Case Report A 5 month old infant presented with history of pain abdomen, intermittent vomiting, fever and blood in stool for 2 days. On examination there is a palpable mass in the right side of the abdomen. On digital rectal examination, finger was stained with blood and no palpable mass was felt. The infant had leucocytosis in complete blood count. Other haematological parameter are within normal limit. Plain radiograph of abdomen was normal. ultrasound of abdomen showed multiple, discrete mesenteric lymph node, largest measuring 25mm in size.Target sign was noted in the ultrasound scan. There was no free fluid or organomegaly noted in the ultrasound. Review ultrasound showed ileocolic intussusception. Patient underwent emergency laparotomy. Intraoperatively a mass was milked through the caecum and ileo-ileocolic intussusception was found. After complete reduction of intussusceptions, a segment(2 cms) of terminal ileum was gangrenous and friable about 5 cms from ileoceacal junction. Resection of the gangrenous ileum and end to end anastamosis of ileum was done. Intraoperatively multiple inflamed mesenteric lymph nodes was found. Largest measuring 20 mm X 10 mm. Biopsy of the mesenteric lymph nodes showed them to be of reactive in nature. Postoperative period was uneventful.