Lymphoma-related intussusception in children: diagnostic challenges and clinical characteristics

Eur J Pediatr. 2024 Jan;183(1):219-227. doi: 10.1007/s00431-023-05289-2. Epub 2023 Oct 20.

Abstract

Intussusception is a common cause of acute abdominal pain in children and the most frequent cause of intestinal obstruction in infants. Although often idiopathic, it can stem from conditions like lymphoma. This study delves into lymphoma-related intussusception in children, aiming to enhance early detection and management. A retrospective review encompassed children admitted from 2012 to 2023 with intussusception due to intestinal lymphoma. Demographic, clinical, and imaging data were meticulously extracted and analyzed. The study included 31 children in the lymphoma-related intussusception group. Contrasted with non-lymphoma-related cases, the patients of lymphoma-related intussusception were notably older (median age: 87 months vs. 18.5 months), predominantly male, and demonstrated protracted abdominal pain. Ultrasound unveiled mesenteric lymph node enlargement and distinct intra-abdominal masses; enema reduction success rates were notably diminished. Detecting lymphoma-related intussusception remains intricate. Age, prolonged symptoms, and distinctive ultrasound findings can arouse suspicion. Timely surgical intervention, based on preoperative imaging, proves pivotal for accurate diagnosis.

Conclusion: Swift identification of lymphoma-related intussusception, distinguished by unique clinical and ultrasound features, is imperative for timely intervention and treatment. Further research is warranted to refine diagnostic approaches.

What is known: • Intussusception in pediatric patients can be caused by a wide spectrum of underlying diseases including lymphoma. • Early Identifying the exact underlying cause of intussusception is crucial for tailored therapy, however often challenging and time-consuming.

What is new: • Lymphoma-related intussusception may present with increased abdominal fluid accumulation, intestinal obstruction, and a higher likelihood of failed reduction during enema procedures. • For high-risk children, repeated ultrasound examinations or further investigations may be necessary to confirm the diagnosis.

Keywords: Children; Diagnosis; Intussusception; Lymphoma; Surgical intervention.

MeSH terms

  • Abdominal Pain / etiology
  • Child
  • Enema / adverse effects
  • Female
  • Humans
  • Infant
  • Intussusception* / diagnosis
  • Intussusception* / etiology
  • Intussusception* / therapy
  • Lymphoma* / complications
  • Lymphoma* / diagnosis
  • Male
  • Retrospective Studies
  • Treatment Outcome