Recurrent ileocolic intussusception with appendiceal lead point in a 2-year-old child: an etiology to be aware of on ultrasound.

Ileocolic intussusception is a differential consideration in young pediatric patients presenting with acute abdominal pain. Appendiceal intussusception is an uncommon variant of ileocolic intussusception where the appendix is contained within the intussusception, which can be challenging to diagnose preoperatively. In this case report, we present a 25-month-old female presenting with intermittent, diffuse abdominal pain. Initial ultrasound evaluation demonstrated ileocolic intussusception, which was successfully reduced by air enema. The patient experienced recurrent symptoms and had several recurrent episodes of ileocolic intussusception with the appendix contained within the intussusceptum. After the fifth recurrence, the patient underwent surgical intervention. The inflamed appendix was discovered to be inverted within the cecum, resulting in a lead point for intussusception of the terminal ileum. The patient underwent laparoscopic reduction of the ileocolic intussusception and appendectomy. Few cases of appendiceal and concurrent ileocolic intussusception are described in the literature. It is important that radiologists and surgeons be aware of this entity when evaluating pediatric ileocolic intussusception, particularly at the time of ultrasound and air enema, in order to ensure appropriate management and prevent complications.

Fertility Treatments and Breast Cancer: A Significant Risk for Our Patients?

Fertility medications have been postulated to increase the risk of breast cancer because of the transient but substantial elevation in hormones occurring with their use. Multiple studies exploring the relationship between fertility medications and risk of breast cancer are limited by the wide variety of fertility treatment regimens and confounded by infertility as an independent risk factor for breast cancer. The Practice Committee Guidelines of the American Society of Reproductive Medicine acknowledge that although this relationship is complex, no additional risk of breast cancer has been consistently linked to infertility medications. This article reviews the major studies both supporting and refuting this statement and makes recommendations regarding risk counseling and breast cancer screening in patients with a history of fertility treatments and infertility.