Abstract
BackgroundIntussuception is a rare cause of intestinal obstruction in adults. Diagnosis is often difficult due to the variable and sometimes episodic nature of symptoms. Surgery is the recommended treatment option in adults if the diagnosis is proven.Case presentationWe present a case of a 33 year old Caucasian female admitted with a small bowel obstruction and no history of previous abdominal surgery. Patient did not improve with medical management consisting of bowel rest and nasogastric tube decompression. Surgery was consulted and patient was taken to the operating room for a laparoscopic-assisted small bowel resection for a small bowel intussusception caused by a submucosal fibroma.ConclusionOur case highlights the feasibility and potential benefits of laparoscopy in assisting the diagnosis and treatment of small bowel obstructions.
Highlights
Intussuception is a rare cause of intestinal obstruction in adults
We report a case of a young female with a bowel obstruction secondary to a small bowel intussusception
Just proximal to the ileocecal valve an area of obstruction was identified, possible relating to an internal hernia (Figure 2)
Summary
Fairly common in children, adult intussusception is relatively rare representing only 1% of patients with bowel obstructions [1,2]. Gastroenterology was consulted and a computed tomography scan was obtained showing edematous small bowel within the pelvis and a questionable internal hernia. Cases Journal 2008, 1:432 http://www.casesjournal.com/content/1/1/432 days after admission showing a possible transition point for her small bowel obstruction and mass like opacity possibly representing intussusception versus an internal hernia (Figure 1). Just proximal to the ileocecal valve an area of obstruction was identified, possible relating to an internal hernia (Figure 2). This area of obstruction was unable to be reduced laparoscopically so the cecum was mobilized laparoscopically. CbwpFoioigtwsmhuseirpbleuioclitsot1esyndibsolitfesotimnetantorutggswerstuaitpshchigeyanpspticniooasrnsigisbhhlteolwosmwinaeglrldbqilouawtaededrlalonobtosprtasriusocinftgisomtnhaell Computed tomography scan showing dilated loops of small bowel consistent with a possible small bowel obstruction with possible target sign in right lower quadrant raising the possibility of intussusception. Http://www.casesjournal.com/content/1/1/432 in follow-up doing well and without complaints (Figure 4.)
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