Ileocecal Intussusception and Obstruction Secondary to Metastatic Melanoma: A Case Report.

Abstract

Intussusception is an uncommoncause of bowel obstruction in adults. Most cases are associated with a pathologiclead point, commonly attributable to benign or malignant tumors. Malignant skin melanoma can metastasizeto the gastrointestinal tract and lead to significant morbidity and mortality ifleft undiagnosed or untreated. In this article, we present the case of a 43-year-old Hispanic female with a history of stage III melanoma on her neck removed four years ago who presented with three weeks of lower abdominal pain, nausea, and vomiting. Abdominal and pelvic imaging showed a high-grade small bowel obstruction with a transition point at the mid-ileum. Diagnostic laparoscopyconfirmed an ileocecal intussusception secondary to a 5 cm mass at the lead point. The patient underwent successful resection of the ileum 5 cm from the intussusception and the ascending colon due to the high risk of malignancy.Pathology of the mass was found to be malignant melanoma, but the resected lymph nodes and omentum did not contain any malignancy. The patient tolerated the procedure well and is currently undergoing chemotherapy.This case demonstrates metastatic melanoma as a rare cause ofintussusceptions in adults.It emphasizes the importance of considering intussusception when evaluating adult patients with classic lower abdominal pain. Prompt surgical intervention is recommended in suspected cases to address the significant likelihood of malignancy, especially in patients with an oncological history.