Abstract
Intussusception is a paediatric condition that rarely presents in adults. We report an exceptional case of ileocolic intussusception prolapsing from the rectum in an adult with Von Recklinghausen′s disease. A 31-year-old man with von Recklinghausen′s disease presented to emergency department with a history of severe abdominal pain, vomits and rectal bleeding. Abdominal computed tomography showed intestinal obstruction probably due to a sigmoidorectal intussusception. Ileum, appendix, cecum and ascending colon were found to be intussuscepting through transverse, descending and sigmoid colon and prolapsing from the rectum during an emergent laparotomy. A right hemicolectomy was performed. An anatomical pathology examination revealed a neurofibroma of the appendix as lead point for intussusception. Intussusception in adults requires early surgical resection regardless of the nature of the initial case. Neurofibroma of the appendix is very rare; although it is benign, prompt resection is recommended because of a high risk of appendicitis and malignant transformation.
Highlights
Intussusception is defined as the telescoping of a segment of the gastrointestinal tract into an adjacent one
We report an exceptional case of ileocolic intussusception prolapsing from the rectum in an adult with Von Recklinghausen’s disease
Appendix, cecum and ascending colon were found to be intussuscepting through transverse, descending and sigmoid colon and prolapsing from the rectum during an emergent laparotomy
Summary
Intussusception is defined as the telescoping of a segment of the gastrointestinal tract into an adjacent one. Intestinal intussusception is common in children, it is rare in adults. Adult intussusception represents 1% of all bowel obstructions and 5% of all bowel intussusceptions, and approximately 90% is secondary to a pathological anatomical condition [1]. It is generally accepted that adult intussusception requires surgical resection, the extent of resection and the question of whether the intussusception should be reduced remain controversial. The aim of this report is to present a rare case of ileocolic intussusception prolapsing from the rectum due to appendiceal neurofibroma in an adult patient with Von Recklinghausen’s disease
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