Postoperative ileocolic intussusception 48 hours after congenital heart surgery in an infant: a case report

TL;DR

A 3-month-old infant developed postoperative ileocolic intussusception 72 hours after heart surgery, requiring surgery after failed non-invasive treatment.

Contribution

This case highlights the rare occurrence of postoperative intussusception after congenital heart surgery in infants.

Findings

Emergency ultrasound confirmed ileocolic intussusception 72 hours after heart surgery.

Three attempts at hydrostatic enema failed, requiring surgical resection of a necrotic bowel segment.

The patient recovered fully and showed normal growth at 6-month follow-up.

Abstract

Postoperative intussusception (PI) is a rare but potentially serious complication following congenital heart surgery in infants, often misdiagnosed due to its atypical presentation.

A 3-month-old male infant underwent aortoplasty, ventricular septal defect (VSD) repair, and patent ductus arteriosus (PDA) ligation for congenital heart disease. Approximately 72 h postoperatively, he developed bloody, jam-like stools. Emergency abdominal ultrasound, the first-line imaging modality, revealed ileocolic intussusception. Three attempts at ultrasound-guided hydrostatic saline enema reduction (pressure: 80 cm H2O) were unsuccessful, necessitating surgical exploration. Laparotomy identified an 8 cm ileocolic intussusceptum and a 10 cm ischemic ileal segment without a pathological lead point. The necrotic bowel was resected, and an end-to-end anastomosis was performed. The patient recovered uneventfully, was discharged three weeks postoperatively, and demonstrated normal growth at 6-month follow-up.

Prompt identification of postoperative intussusception—a rare complication following non-abdominal surgeries like congenital heart disease repair in infants—is of critical importance.

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