Small Bowel Intussusception due to Nasojejunal Tube Placement in Neonates: A Case Report.

INTRODUCTION

Nasojejunal tube placement is a rare cause of small bowel intussusception. It is usually treated with tube removal, but a few cases require surgical reduction. We report a case of small bowel intussusception due to a nasojejunal tube shortly after surgery for ileal atresia, in which surgical reduction was required despite removal of the tube.

CASE PRESENTATION

A female infant underwent intestinal anastomosis for type III-A ileal atresia on the day of birth. A nasojejunal tube was placed for abdominal decompression until the temporary anastomotic passage obstruction improved. Bowel dilatation was successfully resolved; however, bilious gastric residuals suddenly increased again on postoperative day (POD) 11. Sonography revealed small bowel intussusception around the nasojejunal tube. As spontaneous reduction did not occur after tube removal, surgical reduction using the Hutchinson technique was performed on POD 20, including the release of adhesions between the intussusceptum and intussuscipiens of the jejunal intussusception. The patient experienced an uneventful course after surgical reduction.

CONCLUSIONS

Sonography should be performed to screen for small bowel intussusception in patients presenting with bilious vomiting during nasojejunal tube placement. The prompt removal of the tube following a diagnosis of small bowel intussusception (SBI) is essential to prevent adverse events, such as adhesions between the intussuscepted bowel loops. If intussusception does not resolve shortly after tube removal, surgical intervention is indicated.