Incidentally diagnosed intussusception spontaneously resolved in an adult patient after blunt trauma: A rare case report

Abstract

Although intussusception is a rare cause of mechanical bowel obstruction in adults, traumatic intussusception is exceedingly rare. In adults, intussusception contributes less than 1–5% of bowel obstructions. The first report of the diagnosis of intussusceptions was over three centuries ago (1674) by Barbette in Amsterdam. However, the first surgical treatment for this condition in literature was not until almost 100 years later in 1871 by Sir Jonathan Hutchinson, who operated on a child with intussusceptions. Risk factors include age, sex, abnormal peristalsis and pre-existing abdominal pathology. A case of jejunojejunal intussusception in an otherwise healthy 48-year-old female following blunt trauma is presented. The patient was treated conservatively with complete spontaneous resolution of her symptoms. Intussusceptions following blunt trauma is a very rare condition, which may be difficult to diagnose, and usually present as incidental findings. Laparotomy may be necessary in unstable trauma patients and in those individuals whose symptoms of mechanical bowel obstruction fail to resolve in a timely manner or who develop acute peritonitis. In conclusion, intussusception associated with blunt trauma may occur more frequently than previously suspected. Surgical intervention is not always necessary. Conservative management of patients that present with post-traumatic intussusception without other symptomatology may be safely undertaken, unless changes in clinical exam warrant operative intervention. Trauma surgeons should be aware of the possibility of intussusception in any patient that presents with obstructive symptoms after blunt trauma. Early diagnosis is the key to avoiding bowel ischemia and resection.