Abstract
IntroductionThere are several types of small bowel pathology that can lead to small bowel obstruction or intussusception. The etiology causing small bowel obstruction varies by age. Benign disease is the typical cause in children and adolescents while malignant or adhesive disease is far more common in older patients. Although cases of adult intussusception caused by benign processes are rare, there are reports of inflammatory fibroid polyps causing adult intussusception of the terminal ileum published in the literature.Case presentationWe present the case of a 70-year-old man with a multiple year history of intermittent episodes of bowel obstruction who was found to have a giant ileal inflammatory fibroid polyp causing intermittent small bowel obstruction. The patient underwent operative intervention and has now been symptom-free for three years.ConclusionSmall bowel lesions include both malignant and benign etiologies. The malignant etiologies include adenocarcinoma, carcinoid or lymphoma while benign lesions are typically lipomas, inflammatory polyps or adenomas. Inflammatory fibroid polyps are rare, benign lesions that can occur anywhere within the gastrointestinal tract. They are typically an incidental finding, but on rare occasions have been presented as the source of intussusception or obstruction.
Highlights
Case presentation: We present the case of a 70-year-old man with a multiple year history of intermittent episodes of bowel obstruction who was found to have a giant ileal inflammatory fibroid polyp causing intermittent small bowel obstruction
There are several types of small bowel pathology that can lead to small bowel obstruction or intussusception
Cases of adult intussusception caused by benign processes are rare, there are reports of inflammatory fibroid polyps causing adult intussusception in the terminal ileum published in the literature
Summary
Bowel obstruction can occur as a result of a mechanical blockage or dysfunction of the small or large intestine. IFPs were first described in the literature as "gastric submucosal granuloma with eosinophilic infiltration" in a study by Vanek in 1949 They later became recognized under a variety of different names: inflammatory pseudotumor, granuloma with eosinophils, eosinophilic granuloma, and polyp with eosinophilic granuloma. The occurrences of inflammatory fibroid polyps in the small intestine are rare, accounting for only 18% of all cases [6]. This case is one of the few reported in the literature where intussusception is caused by a terminal ileum inflammatory fibroid polyp, Table 1[3,7,8,9,10,11]. While this was a consideration in our case, the Crohn's like inflammatory response is con-
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