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January 31, 1977


JAMA. 1977;237(5):448. doi:10.1001/jama.1977.03270320026008

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To the Editor.—  Carleton and Ackerbaum's interesting and unusual case report (236:1047, 1976) concludes with a statement open to serious misinterpretation.In stating "sections should be taken of all leading edges of intussusceptions..." in their concluding sentence, I hope the authors are simply suggesting that in the occasional case where an intussusception is irreducible and resection must be carried out, the pathologist carefully seek a possible lead point, such as a nodule of aberrant pancreas.It is well known that most intussusceptions do not have lead points (other than hyperplastic lymphoid tissue in the bowel wall) and can be reduced either hydrostatically without surgical intervention or mechanically in the operating room. The more common lead points, such as polyps or Meckel diverticula, are unlikely to be missed. I am afraid that some readers, persuaded by the authors' suggestion, may open the bowel in reducible intussusceptions in order to biopsy the