Intussusception Presenting as Intestinal Obstruction in Pregnancy: A Case Report from a Tertiary Hospital in Ghana

Musah Yakubu,Edmund Muonir Der,Anwar Sadat Seidu,Mohammed Sheriff,David Putiero Suoseg,Emmanuel Agoswin Noah Azure

doi:10.12691/ajmcr-8-12-7

Abstract

There is paucity of scientific data on intussusception in pregnancy globally which makes it a rare clinical occurrence. The symptoms in pregnancy may mimic obstetric conditions and thus presents a diagnostic dilemma to clinicians. A high index of suspicion is therefore needed in order to establish a preoperative diagnosis. We present a 29-year old woman, gravida 5 para 4, 2 alive and 2 dead (G5P42A+2D) at 23-weeksâ 6 days gestation from northern Ghana, who was referred to Tamale Teaching Hospital (TTH) as a case of acute abdomen. Initial clinical assessment and bedside ultrasonography led to a diagnosis of intussusception. A viable colo-colic intussusception was found on open laparotomy and a left hemicolectomy was performed. This was confirmed by histopathological examination of the resected bowel. There was no identifiable lead point. This case report illustrates how good and prompt initial clinical assessment supported with imaging led to a successful outcome of acute abdomen in pregnancy in a low â middle resource country.

Highlights

Intussusception is the invagination of a segment of bowel into a distal segment, resulting in bowel obstruction and compromising the blood supply of the bowel if not attended to promptly [1,2,3,4,5,6]
Intussusception in pregnancy is rare globally [11,12,13,14,15,16]. Symptoms such as abdominal pain, nausea and vomiting may mimic obstetric symptoms, so a high index of suspicion is usually needed in pregnancy [8,18,27]
We present a rare case of intussusception in pregnancy in a low-middle resource setting and illustrated how good clinical assessment and bedside ultrasonography led to confirmation of the diagnosis

Summary

Introduction

Intussusception is the invagination of a segment of bowel (intussusceptum) into a distal segment (intussuscepiens), resulting in bowel obstruction and compromising the blood supply of the bowel if not attended to promptly [1,2,3,4,5,6]. It is a common pediatric surgical emergency, accounting for 95% of cases of intestinal obstruction, compared to only 5% in adults [7,8,9,10]. We present a rare case of intussusception in pregnancy in a low-middle resource setting and illustrated how good clinical assessment and bedside ultrasonography led to confirmation of the diagnosis

Case Presentation

Histopathology

Discussion

Findings

Conclusion