Idiopathic bowel intussusception in adults: case report

Abstract

Introduction: Intussusception in adults is a rare entity, representing only 5% of all cases of intussusception. It represents 1% of all cases of intestinal obstruction, and in adults normally have an underlying organic cause (11-91% of cases). However, 8-21% of cases are idiopathic.

Clinical case: Patient, 19 years, history of prostatectomy, inguinal hernia repair, hydrocele correction and bilateral hip prothesis, referred to emergency department to partial obstruction, with 48 hours of evolution, admitted for conservative treatment. On second day, the patient presents worsening abdominal pain, and made TC: “distended loops of small bowel, sausage image in the right inferior abdominal region compatible with ileocecal intussusception.” Submitted to right hemicoletomy complicated by surgicall site infection. Discharged after 28 days. Histopathologycal examination revealed “areas of transmural ischemic necrosis and inflammation, compatible with ileocecal intussusception without dysplasia or malignant lesions.” No further complications at follow-up at first 3 months.

Discussion / Conclusion: The intussusception in adults is a rare cause of abdominal pain that should be considered in the differential diagnosis of partial or complete intestinal obstruction. The authors reported a case of ileocecal intussusception without underlying organic cause, which emphasizes the role of CT as a method of choice in diagnostic imaging of intussusception in adults.

Keywords: intussusception, ileocecal intussusception, intestinal obstruction, diagnosis, treatment.