Multiple Intussusceptions as the Cause of Death in Asymptomatic neonate: A rare case report

Abstract

Intussusception, a major cause of intestinal obstruction in childhood. The most common type is ileocolic, followed by ileo-ileal.  Intussusception has a peak incidence between three to nine months (Pollack and Pender, 1991) and has a male predominance. Autopsy  proof of both intussusception and peritonitis is needed for pronouncement of death from aggravated intussusception. Frequent vomiting,  secondary to ileus, may lead to aspiration and suffocation when it may be impossible to demonstrate peritonitis, even with confirmed  intussusception. If no pathological lead point, intussusception is likely to represent a primary rather than secondary phenomenon. The  cause of intussusception is not known in most of the cases. Several association and possible causative factors have been identified like  large peyer's patches, polyps, Meckel diverticula, cystic fibrosis, lymphoma, viral etiology particularly adenovirus, recent history of upper  respiratory illness and heredity. It is important to clearly distinguish agonal intussusception from antemortem intussusception. Agonal  intussusceptions are believed to occur terminally are an incidental finding, not a cause of death although designation of the intussusception  as 'agonal' cannot be justified by some authors. We report a case of a 7 days old male child with history of not accepting feed for 1 day who  was brought dead. Five ileo-ileal intussusceptions were evident grossly at autopsy and histopathological examination was diagnostic of  cause of death. Multiple antemortem intussusception as cause of death is fairly uncommon and no ample literature was available for  reference and hence reporting the interesting case.