Beyond lead points: transient small-bowel intussusception in adolescents without structural lesions

Intussusception is a leading cause of intestinal obstruction in young children but remains uncommon in adolescents, where structural lead points typically predominate. Functional or transient small-bowel intussusception without anatomical lesions is rare and often under-recognized in this age group. We report two adolescents presenting with acute abdominal pain and vomiting. Case 1 involved a 15-year-old girl on SSRI therapy with jejuno-ileal intussusception that spontaneously reduced during laparoscopy; localized hematoma, marked hyperperistalsis and venous congestion were observed without structural lead points. Case 2 involved a 13-yearold boy with heterozygous β-thalassemia and ileo-ileal intussusception associated with reactive mesenteric lymph nodes; laparoscopic reduction was successful. These cases illustrate non-structural mechanisms of adolescent intussusception, including SSRI-associated hypermotility and reactive lymphoid hyperplasia. Recognition of these factors, combined with prompt laparoscopic assessment, ensures optimal management, and prevents ischemic complications.