Abstract
IntroductionThe occurrence of intussusception in adults is rare. The condition is found in 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. The child to adult ratio is 20:1.Case presentationA 52-year-old Irish Caucasian woman was investigated for a 3-month history of intermittent episodes of colicky midgut pain and associated constipation. Ileocolonoscopy revealed a pedunculated lesion in the terminal ileum prolapsing into the caecum. Computed tomography confirmed a smooth-walled, nonobstructing, low density intramural lesion in the terminal ileum with secondary intussusception. A laparoscopic small bowel resection was performed. Histology revealed a large pedunculated polypoidal mass measuring 4 × 2.5 × 2 cm consistent with a submucosal lipoma. She had complete resolution of her symptoms and remained well at 12-month follow-up.ConclusionThis case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation. Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning.
Highlights
The occurrence of intussusception in adults is rare
This case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation
Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning
Summary
We illustrate the importance of a thorough interdisciplinary evaluation of patients with midgut abdominal pain. It highlights the diagnostic values of CT scanning and completed ileocolonoscopy. Consent Written informed consent was obtained from our patient for publication of this case report and any accompanying images. Author details 1Division of Colorectal Surgery, Adelaide and Meath Incorporating the National Children’s Hospital, Tallaght, Dublin 24, Ireland. Authors’ contributions NOA contributed in collecting the requisite literature and wrote the case report. DOK collected the requisite literature and reviewed the literature. DCM contributed in collecting the requisite literature.
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