Br. J. Surg. Vol. 63 (1976) 452
Double intussusception of the small bowel through a patent vitello-intestinal duct R. M U S T A F A * SUMMARY
A case of double intussusception through n patent vitello-intestinal duct is reported. The rarity of' this condition is the reason for this short report. Case report A full-term infant aged 32 days was admittcd to Mosul General Hospital on 2 June 1975 because of bowel protruding through
the umbilicus of 2 hours' duration. There were no symptoms. The mother gave a history of the child having mucus and sometimes faeculant discharge from the navel since birth. Thirty minutes after arrival at hospital a second loop appeared beside the first (Fig. 1). Each loop was about 15 cm in length. The general condition of the patient was good.
A n emergency laparotomy was performed through a left paramedian incision which revealed two intussusceptions, one antegrade from the proximal intestine and one retrograde from the distal intestine, both protruding through a patent vitellointestinal duct. The intussusceptions were manually reduced. The vitello-intestinal duct, which measured just over 1 cm in length, was resected and the incision closed transversely. The patient had an uneventful convalescence.
Discussion This condition warrants immediate surgical treatment (Kling, 1968) for delay might result in gangrene. Retrograde intussusception is very rare and was first reported by Soutar et al. (1958) in a case of double intussusception. The present case is another example of antegrade and retrograde intussusception. The exact nature of the condition was ascertained only after laparotomy. Progressive prolapse of the vitello-intestinal duct will produce a T-shaped protrusion. This appearance seems to depend on the length of the duct; if it is a long one i t will be obvious, as in Soutar's case, but if it is short it may not be visible and the loops will appear to be coming separately through the umbilicus, as in the present case. References
s. (1968) Patent omphalomesenteric ducta surgical emergency. Arch. Surg. 96, 545-548. SOUTAR s. F., DOUGLAS D. M. and DENNISON w. M. (1958) Patent vitello-intestinal duct. The risk of obstruction due to prolapse. Br. J . Surg. 45, KLING
6 17-620. Fig. 1. Photograph showing both loops of the small bowel (antegrade and retrograde intussusceptions) protruding through thc umbilicus and lying on the abdominal wall.
452
* Department of Surgery, Mosul University College of Medicine, Iraq.
Double intussusception of the small bowel through a patent vitello-intestinal duct R. M U S T A F A * SUMMARY
A case of double intussusception through n patent vitello-intestinal duct is reported. The rarity of' this condition is the reason for this short report. Case report A full-term infant aged 32 days was admittcd to Mosul General Hospital on 2 June 1975 because of bowel protruding through
the umbilicus of 2 hours' duration. There were no symptoms. The mother gave a history of the child having mucus and sometimes faeculant discharge from the navel since birth. Thirty minutes after arrival at hospital a second loop appeared beside the first (Fig. 1). Each loop was about 15 cm in length. The general condition of the patient was good.
A n emergency laparotomy was performed through a left paramedian incision which revealed two intussusceptions, one antegrade from the proximal intestine and one retrograde from the distal intestine, both protruding through a patent vitellointestinal duct. The intussusceptions were manually reduced. The vitello-intestinal duct, which measured just over 1 cm in length, was resected and the incision closed transversely. The patient had an uneventful convalescence.
Discussion This condition warrants immediate surgical treatment (Kling, 1968) for delay might result in gangrene. Retrograde intussusception is very rare and was first reported by Soutar et al. (1958) in a case of double intussusception. The present case is another example of antegrade and retrograde intussusception. The exact nature of the condition was ascertained only after laparotomy. Progressive prolapse of the vitello-intestinal duct will produce a T-shaped protrusion. This appearance seems to depend on the length of the duct; if it is a long one i t will be obvious, as in Soutar's case, but if it is short it may not be visible and the loops will appear to be coming separately through the umbilicus, as in the present case. References
s. (1968) Patent omphalomesenteric ducta surgical emergency. Arch. Surg. 96, 545-548. SOUTAR s. F., DOUGLAS D. M. and DENNISON w. M. (1958) Patent vitello-intestinal duct. The risk of obstruction due to prolapse. Br. J . Surg. 45, KLING
6 17-620. Fig. 1. Photograph showing both loops of the small bowel (antegrade and retrograde intussusceptions) protruding through thc umbilicus and lying on the abdominal wall.
452
* Department of Surgery, Mosul University College of Medicine, Iraq.
