Tuesday, December 7, 2010

Lymphoma; a common cause of Intussusception above 6 years

An 8 year old is seen in the emergency room secondary to abdominal pain. Further evaluation confirms the presence of intussusception. The most likely precipitating cause is

  • A) colon polyp
  • B) Meckel's diverticulum
  • C) lymphoma
  • D) parasite infection
  • E) foreign body

The answer is ( C ).
Intussusception is the most common cause of intestinal obstruction in the first 2 years of life. It is more common in males than in females. In most cases (85%) the cause is not apparent. Associated conditions that can result in intussusception include polyps, Meckel's diverticulum, Henoch–Schönlein purpura, lymphoma, lipoma, parasites, foreign bodies, and viral enteritis with hypertrophy of Peyer patches.

Intussusception of the small intestine occurs in patients with celiac disease and cystic fibrosis—related to the bulk of stool in the terminal ileum. Henoch–Schönlein purpura may also cause isolated small-bowel intussusception. In children older than 6 years, lymphoma is the most common cause. Intermittent small-bowel intussusception is a rare cause of recurrent abdominal pain.

Labels: , ,