Jejuno-jejunal intussusception following open drainage of hepatic abscess

Postoperative jejunojejunal intussception after surgical drainage of hepatic abscess in a toddler is extremely rare, and reports of this special type of postoperative small bowel intussusception are scarce in the literature. The case of a 2-year-old toddler who developed post-operative intussusception following an open drainage of hepatic abscess was retrospectively reviewed. Clinical features, diagnostic strategy, operative findings and outcome were reviewed. He developed vomiting with crankiness suggestive of abdominal colics on the fifth post-operative day; haven been commenced on oral intake 48 h earlier. Physical examination revealed signs of dehydration, upper abdominal fullness and hyperactive bowel sounds. Plain abdominal x-ray showed multiple centrally located air fluid levels with paucity of gas in the pelvis. A conservative approach of “suck, drip and drain” was initially commenced but with worsening of symptoms laparotomy was done where a jejunojejunal intussception (with viable gut) was discovered. Manual reduction was done and the postoperative management was uneventful. This case highlights the need for a high index of suspicion of post-operative intussusception whenever paediatric patients have significant abdominal colics post laparotomy.