Intussusception in a child with Acute Lymphoblastic Leukemia: a remarkable presentation with literature review - a case report

J Egypt Natl Canc Inst. 2021 Jul 29;33(1):18. doi: 10.1186/s43046-021-00079-z.

Abstract

Background: Gastrointestinal complications are not uncommon in patients of Acute Leukemia. Intussusception as a complication in leukemia, although described, is exceedingly rare. Also, it is usually seen after chemotherapy and not as a part of the native disease process. This case report aims to highlight such a rare association which warrants clinical and pathological attention.

Case presentation: A 14 year old male presented with an acute abdomen. Initial routine investigations revealed a deranged blood picture. On further examination of bone marrow aspirate, biopsy and detailed immunohistochemical studies a diagnosis of B-Acute Lymphoblastic Leukemia (B-ALL) was made. Concurrent ultrasound of the abdomen to find a cause for severe abdominal pain revealed an Ileo-colic intussusception. The patient was started on steroids; however he succumbed to his illness after two days, before surgery could be attempted.

Conclusion: Rare presentations of relatively common diseases are a hurdle for timely and effective medical intervention. Although a rare condition in itself in leukemic patients, the occurrence of Intussusception in this particular patient, especially when no chemotherapy was initiated, is a very rare event. This case report was made to add to the relatively scarce literature available on this particular association. As it is a surgically treatable condition and since delay in diagnosis may lead to poorer prognosis, possibility of co-existence of ALL and intussusception should be borne in mind by all treating physicians and hematopathologists for effective patient care.

Keywords: Acute Lymphoblastic Leukemia; Gastrointestinal Complications; Hematopathology; Intussusception; Surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biopsy
  • Child
  • Humans
  • Intussusception* / diagnosis
  • Intussusception* / etiology
  • Leukemia, Myeloid, Acute*
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / diagnosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • Ultrasonography