A Rare Cause of Intussusception in an Adolescent Female

Abstract

Question: A 14-year-old girl with a prior diagnosis of anorexia nervosa and 2 prior hospital admissions in the past 40 days owing to severe dehydration, acute kidney injury, and electrolyte derangements presented to the hospital to manage restrictive eating and purging behaviors. On day 7 of admission, she had an upper gastrointestinal barium study with findings of superior mesenteric artery obstruction of the duodenum. The patient subsequently was managed with nasojejunal feedings past the level of this obstruction for 1 month. She continued to complain of intermittent abdominal pain, emesis, and mild tenderness to palpation on physical examination. During this hospitalization, the patient developed multiple episodes of nonbloody, nonbilious emesis with associated abdominal pain. A subsequent computed tomography imaging of the abdomen and pelvis demonstrated an intestinal obstruction secondary to a long-segment duodenal–jejunal intussusception with concern for bowel ischemia involving the distal duodenum (Figure A). CME Exam 1: A Rare Cause of Intussusception in an Adolescent FemaleGastroenterologyVol. 163Issue 2Preview Full-Text PDF