A rare case of adult ileo-colic intussusception: Hamartomatous polyp as a lead point with concurrent appendiceal neurofibroma in Neurofibromatosis Type 1

doi:10.28933/ijcr-2021-01-2505

Abstract

Intussusception is a rare cause of adult intestinal obstruction and unlike in children, adult intussusception is commonly caused by a lead point, requiring surgical intervention in most cases. Hamartomatous polyp is a non-neoplastic growth of tissue containing mature cells, distributed in an abnormal manner. It is often associated with intestinal polyposis syndromes such as Peutz-Jeghers syndrome and Juvenile polyposis. In the current case, we report an extremely rare case of ileo-colic intussusception secondary to a lead point of an isolated ileal hamartomatous polyp in an elderly gentleman with Neurofibromatosis type-1. Patient was successfully treated with ileo-colic resection involving the intussuscepted segment of bowel. There was an incidental finding of a nodule in the appendix and the histology confirmed this as a neurofibroma. Post-operative recovery of the patient was unremarkable.

Highlights

Intussusception is a condition where there is a telescoping of one segment of bowel into the adjacent one [1]
In Contact number: +612 5124 0000 the current case, we report an extremely rare case of ileo- Address: Department of General colic intussusception secondary to a lead point of an isolated Surgery, The Canberra Hospital, ileal hamar tomatous polyp in an elderly gentleman with Yamba Drive, Garran 2605 ACT
Unlike in children where the aetiology is idiopathic, adult intussusception is commonly caused by a pathologic lead point, requiring surgical intervention [3]

Summary

Background

Intussusception is a condition where there is a telescoping of one segment of bowel into the adjacent one [1]. The current case describes an extremely rare but unique presentation of an ileo-colic intussusception secondary to a lead point of an ileal HP and concurrent appendiceal neurofibroma in a patient with NF1 and its surgical management. He denied similar experience in the past His medical background included NF1 with café au-lait skin lesions and neurofibromas on his torso and upper back with no known other organ involvement. Multiple Café-au-lait lesions and neurofibromas on his chest and abdomen were noted (Figure 2). On laboratory evaluation, he had haemoglobin of 123g/L [135180g/L], white cell count (WCC) of 17.2 [4.0-11.0] x 10^9/L, creatinine of 63umol/L [60-110umol/L] and C-reactive protein (CRP) of 1.1 mg/L [

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Discussion

Conclusion