Recognizing Postoperative Intussusception: Lessons from Four Pediatric Cases

Sandip Kumar Rahul¹, Rupesh Keshri², Digamber Chaubey³, Pallavi Suman⁴, Sourabh Chandrabhushan Sharma⁵, Mausam Singh⁶

Keywords: Intussusception, postoperative complications, Wilms’ tumor, congenital diaphragmatichernia, child

DOI: 10.63475/yjm.v5i2.0390

DOI URL: https://doi.org/10.63475/yjm.v5i2.0390

Publish Date: 25-07-2026

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Pages: 444 - 450

Downloads: 3

Citation: 0

Author Affiliation:

1 Additional Professor, Department of Pediatric Surgery, AIIMS Deoghar, Jharkhand, India
2 Associate Professor, Department of Pediatric Surgery, AIIMS Deoghar, Jharkhand,India
3 Associate Professor, Department of Pediatric Surgery, AIIMS Patna, Bihar, India
4 Resident, Department of Anesthesiology, Tata Main Hospital (TMH), Jamshedpur, Jharkhand, India
5 Resident, Department of Pediatric Surgery, AIIMS Deoghar, Jharkhand, India
6 Resident, Department of Pediatric Surgery, AIIMS Deoghar, Jharkhand, India

Abstract

Postoperative intussusception (PI) is a rare but serious complication following abdominal surgery in children. Its diagnosis is challenging due to overlapping features with postoperative ileus, electrolyte disturbances, and other factors affecting the return of normal peristalsis. Delayed recognition can lead to bowel ischemia and increased morbidity. In this case series, four cases of PI were identified among 13,742 abdominal surgical procedures performed during the last 5 years (incidence: 0.029%). All patients were male, aged 7 months to 3 years. Three cases occurred following left nephroureterectomy with lymph node sampling for Wilms’ tumor, and one followed repair of a left-sided congenital diaphragmatic hernia. All children became symptomatic between postoperative days 6 and 7, presenting with bilious vomiting, abdominal pain/ distension, and inconsolable crying—symptoms that emerged after oral feeding had commenced. Ultrasound confirmed the diagnosis in all cases, demonstrating the characteristic bowel-withinbowel appearance. Two cases with ileo-ileal intussusception underwent immediate operative manual reduction. Two cases with ileo-colic intussusception had unsuccessful ultrasound-guided hydrostatic reduction followed by successful operative reduction. All reduced bowel segments appeared viable without identifiable lead points. All patients recovered uneventfully, though the first postoperative chemotherapy dose was delayed in the three Wilms’ tumor patients. therefore, PI should be considered in any child presenting with bilious vomiting and abdominal symptoms toward the end of the first postoperative week, particularly following retroperitoneal surgery. Early ultrasound examination and prompt surgical intervention, when indicated, are essential to minimize morbidity. A high index of suspicion remains the cornerstone of timely diagnosis.

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