Ileocolic Intussusception - A rare cause of acute intestinal obstruction in adults; Case report and literature review

Muhammad Khan,Avi Agrawal,Paul Strauss

doi:10.1186/1749-7922-3-26

Abstract

Colonic Intussusception although common in children, is a rare cause of acute intestinal obstruction in adults. The etiology, clinical presentation and management of this condition is different in adults as compared to children. Pre-operative diagnosis is usually difficult due to the non specific and intermittent nature of the symptoms. CT scan can be a helpful adjunct in establishing the diagnosis. We present a case report of adult ileocolic intussusception with classical radiological signs and operative findings. A brief literature review is also presented with emphasis on the controversy of reduction of the intussusception before resection.

Highlights

A 74 year old male presented with a four month history of colicky right upper quadrant pain, altered bowel habits and weight loss
Intussusception is an uncommon cause of intestinal obstruction and more than 95% of cases occur in the paediatric age group [1]
Intussusception in adults is a rare pathology its incidence is around 2–3 per 1000,000 per year [2]. Due to this rare nature of the disease there are no large scale/multi-centre studies or meta-analyses published to investigate the management of adult intussusception

Summary

Introduction

A 74 year old male presented with a four month history of colicky right upper quadrant pain, altered bowel habits and weight loss. An abdominal USS showed a 5 × 7 cm ill defined bowel related mass in the right upper quadrant. CT scan of the abdomen showed significantly thickened bowel loops with fat density within a proximal segment and a target lesion, consistent with a neoplasm or a lipoma causing Intussusception (Figure 2). A provisional diagnosis of colonic carcinoma was made the tumour markers including CEA and CA 19.9 were normal.

Results

Conclusion