Postoperative intussusception after congenital diaphragmatic hernia repair: A report of 2 cases

Abstract

A postoperative intestinal intussusception is one of complications after abdominal surgery. However current evidence of intussusception after congenital diaphragmatic repair still received little attention. There are few publications mentioned about cause of intussusception. Previous literature reported possible cause from atony of the herniated bowel that could be a functional leading point of intussusception. In our institute, 2 patients developed postoperative intussusception after CDH repair. We reported case of a 12-day-old male newborn presented with history of respiratory distress in newborn. He was diagnosed as congenital diaphragmatic hernia with pulmonary hypertension. The chest X-ray showed the presence of bowel loop in the left hemithorax. After congenital diaphragmatic hernia repair, this patient develops intestinal obstruction symptoms. The explorative laparotomy emergency evidenced a jejuno-jejunal intussusception. And we reported case of a 7-month-old female with history of respiratory distress in newborn. She was scheduled for diaphragmatic hernia repair. The chest X-ray showed the presence of large soft tissue density at the posterior aspect of the left hemithorax. She early came to OPD due to many episodes of non-bilious vomiting and abdominal distension. There was suspected clinical of gastric volvulus. Explorative laparotomy emergency was carried out. Congenital diaphragmatic hernia repair with anterior gastropexy was performed. On the seventh postoperative day, this patient develops intestinal obstruction symptoms. The second explorative laparotomy emergency evidenced a jejunoileal intussusception. Our report concerned about cause of post congenital diaphragmatic hernia repair with intestinal obstruction. A postoperative intussusception in congenital diaphragmatic hernia repair should be concerned. However, further studies are needed to elucidate the causes of postoperative intussusception.