Abstract
Background. Adult intussusception is a rare entity representing less than 1% of all intestinal obstructions. Diagnosis of the condition is difficult requiring a high index of suspicion and the utilization of imaging studies, especially CT scans. Diagnostic laparoscopy and/or exploratory laparotomy can be used as a diagnostic and therapeutic intervention. In over 90% of cases, an underlying lead point is identified. In the patient described here, it was a gastrointestinal stromal tumor (GIST), a relatively rare mesenchymal tumor comprising only 0.2–1.0% of the gastrointestinal tract neoplasms and believed to originate from neoplastic transformation of the interstitial cells of Cajal. GISTs may occur anywhere along the gastrointestinal tract, but most commonly arise in the stomach and small intestine. Literature review revealed only few cases reporting GISTs as a leading point of adult's intussusception. Case Presentation. In this report, we are presenting a rare case of jejunojejunal intussusception in a 78-year-old female patient with a GIST located in the terminal jejunum being the leading point, demonstrating the importance of imaging studies, especially CT scan, laparoscopy, and exploratory laparotomy as diagnostic and therapeutic interventions.
Highlights
Intestinal invagination or intussusception is the leading cause of intestinal obstruction in children, but it is an uncommon process in adults, accounting for only 5% of all intussusceptions and 1% of all intestinal obstruction
Unlike childhood intussusception which is idiopathic in 90% of cases, 70–90% of adult cases have a demonstrable lead point, with a well-definable neoplastic abnormality being the etiology in 65% of cases [1, 2]
They are associated with nonspecific symptoms unless complicated with ulceration and overt GI bleeding (40% of the cases) or grow large enough to cause pain, mass or a lead point of intussusception and intestinal obstruction (20% of the cases) [12]
Summary
Adult intussusception is a rare entity representing less than 1% of all intestinal obstructions. Diagnosis of the condition is difficult requiring a high index of suspicion and the utilization of imaging studies, especially CT scans. Diagnostic laparoscopy and/or exploratory laparotomy can be used as a diagnostic and therapeutic intervention. In over 90% of cases, an underlying lead point is identified. Literature review revealed only few cases reporting GISTs as a leading point of adult’s intussusception. We are presenting a rare case of jejunojejunal intussusception in a 78-year-old female patient with a GIST located in the terminal jejunum being the leading point, demonstrating the importance of imaging studies, especially CT scan, laparoscopy, and exploratory laparotomy as diagnostic and therapeutic interventions
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