What are the surgical lead points in intussusception?

Updated: Dec 20, 2018
  • Author: A Alfred Chahine, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

In approximately 2-12% of children with intussusception, a surgical lead point is found. Occurrence of surgical lead points increases with age and indicates that the probability of nonoperative reduction is highly unlikely. Examples of lead points are as follows:

  • Meckel diverticulum [3]

  • Enlarged mesenteric lymph node

  • Benign or malignant tumors of the mesentery or of the intestine, including lymphoma, polyps, ganglioneuroma, [4] and hamartomas associated with Peutz-Jeghers syndrome

  • Mesenteric or duplication cysts

  • Submucosal hematomas, which can occur in patients with HSP and coagulation dyscrasias

  • Ectopic pancreatic and gastric rests

  • Inverted appendiceal stumps

  • Sutures and staples along an anastomosis

  • Intestinal hematomas secondary to abdominal trauma

  • Foreign body

  • Hemangioma

  • Post-transplantation lymphoproliferative disorder (PTLD) [6]


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