Postoperative intussusception after congenital diaphragmatic hernia repair: a report of 2 cases

Background: A postoperative intestinal intussusception is one of complications after abdominal surgery. However current evidence of intussusception after congenital diaphragmatic repair still received little attention. Previous literature reported possible cause from atony of the herniated bowel that could be a functional leading point of intussusception. Case report: A 7-month-old female with history of respiratory distress in newborn, with no obvious abdominal signs was scheduled for diaphragmatic hernia repair. The chest X ray showed the presence of large soft tissue density at the posterior aspect of the left hemothorax. She early came to OPD due to many episodes of non-bilious vomiting and abdominal distension. The plain abdomen showed marked dilate of stomach suspected gastric volvulus. Explorative laparotomy emergency was performed in this case. Congenital diaphragmatic hernia repair with anterior gastropexy was performed. On the seventh postoperative day, this patient develops intestinal obstruction symptoms with bilious vomiting. The second explorative laparotomy emergency evidenced a jejunoileal intussusception with absence of leading point. A 17-day-old male newborn presented with history of respiratory distress in newborn. He was diagnosed as congenital diaphragmatic hernia with pulmonary hypertension. The chest X ray showed the presence of bowel loop in the left hemothorax. After congenital diaphragmatic hernia repair, on the twelfth postoperative day, this patient develops intestinal obstruction symptoms. The explorative laparotomy emergency evidenced a jejuno-jejunal intussusception with absence of leading point. Conclusion: A postoperative intussusception in congenital diaphragmatic hernia repair should be concerned. However, further studies are needed to elucidate the causes of postoperative intussusception.