A Rare twist: Case report of pediatric colo-colonic intussusception secondary to colonic schwannoma.

INTRODUCTION AND IMPORTANCE

Intussusception is a rare, but serious cause of abdominal pain that must be considered in pediatric emergency medicine, especially in younger patients.

CASE PRESENTATION

This report describes an 11-year-old male who presented to the emergency department (ED) with intermittent, waxing and waning abdominal pain, that later diagnosed as colo-colonic intussusception due to a colonic schwannoma lead point. Initial abdominal ultrasound revealed a complicated cystic at the descending colon. Follow-up computed tomography scan confirmed colo-colonic intussusception with a solid intra-luminal mass. Subsequent colonoscopy identified a five-centimeter broad based polypoid tumor at the splenic flexure which was non-resectable endoscopically. Left colon segmentectomy was performed removing six centimeters of bowel. Pathology diagnosed a benign colonic spindle schwannoma. Genetic screening was unremarkable, indicating a sporadic schwannoma that did not require additional surveillance or follow-up.

CLINICAL DISCUSSION

Pediatric intussusception most commonly presents in individuals three months to six years of age, making the above individual outside of the typical presenting age. In addition, the lead point in this case, colonic schwannoma is incredibly rare, particularly in the pediatric population. The patient also had a colo-colonic intussusception which is not the typical location of pediatric intussusceptions.

CONCLUSION

This case illustrates that, although most common in very young children, intussusception can occur at any age with the presence of a focal lead point and must remain on the differential diagnosis.