Multiple Small Bowel Intussusceptions Detected by Diagnostic Laparoscopy in an Adult Patient with Previously Undiagnosed Coeliac Disease.

Abstract

Enteric intussusception in adults is usually associated with the presence of a lead point seen on abdominal computerized tomography. However, as intussusception in coeliac disease may not have a lead point, a surgical procedure is often indicated in order to exclude small bowel tumour. We present the case of a male patient who presented with asymptomatic small bowel intussusception. During exploratory laparoscopy, five enteric intussusceptions were detected and a suspicion for coeliac disease was raised. Postoperative duodenal biopsy and CD3 immunohistochemical staining confirmed the diagnosis of coeliac disease, Marsh type 1.LEARNING POINTSCoeliac disease can present initially with multiple small bowel intussusceptions.Intussusceptions in coeliac disease present without a lead point.In such cases, diagnostic laparoscopy can help to establish the diagnosis.