Small bowel intussusception in 2 adults caused by inflammatory polyps

Inflammatory fibroid polyp (Vanek's tumor) causing double compound ileo-ileal intussusception in an adult patient, a case report

Introduction and importance

Case report

Clinical discussion

Conclusions

Interventions and outcome

Methods

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Intussusception is a condition in which there is telescoping ladder f one bowel segment into another resulting in mechanical bowel obstruction.

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While intussusception is considered a common condition in infants and young children, it is rare in adults. It is not common to have two lead points (Double intussusception) for the disease, causing symptoms simultaneously.

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In this case, we report a case of double intussusception in an adult patient, something that has been reported in only handful of cases worldwide.

Adult Jejuno-jejunal intussusception due to inflammatory fibroid polyp: A case report and literature review

RATIONALE

Intussusception is defined as the invagination or telescoping of a proximal portion of the intestine into the distal portion of the intestine. Intussusception can occur at any age but is more common among children. Most cases of intussusception in adults have a pathological lead point. Inflammatory fibroid polyp (IFP) is a rare benign tumor-like lesion arising from the submucosa of the gastrointestinal tract that can cause intussusception in adults. Here, we report a case of adult intussusception due to IFP. We also present a literature review of 31 reports including 34 cases between 2012 and December 2019, which shows a mean age of 45.4 ± 14.2 years and female dominance (23/34) of intussusception due to IFP.

PATIENT CONCERNS

A 47-year-old man presented with a half-day history of epigastric abdominal pain. Physical examination revealed distension and tenderness of the upper abdomen. Computed tomography (CT) of the abdomen and pelvis demonstrated intussusception of the jejunum along with a suspicious jejunal mass associated with mesenteric lymphadenopathies.

DIAGNOSIS

Intussusception of the jejunum along with a suspicious jejunal mass, and histopathological examination of the resected specimen showed IFP.

INTERVENTIONS

The patient underwent emergency laparotomy. The intussusception was resected without attempts for reduction.

OUTCOMES

The postoperative period was uneventful, and the patient was discharged on the fourth postoperative day.

LESSONS

Intussusception in adults is rare, especially that secondary to IFP. The most commonly used diagnostic tool for adult intussusception is abdominal CT, and the optimal management is resection of the involved bowel segment without reduction if malignancy cannot be ruled out.