Abstract
Intussusceptions are rare but well-known causes of the small bowel obstruction in adults and an underlying cause is present in the majority of cases. Lymphoma's involvement of the ileum is one of the rare causes of intussusception. CT is a sensitive examination that diagnoses intussusceptions and provides an excellent pre-operative evaluation including possible extension and dissemination especially in intestinal lymphomas. The treatment is almost always surgical and the pathological study is needed for diagnostic confirmation. Authors present an unusual case of intestinal intussusception due to lymphoma of the terminal part of the ileum in a 49-year-old man. Computed tomography confirmed the diagnosis of intussusception and non-Hodgkin's lymphoma of B-cell was diagnosed by histological examination after surgical treatment. Primary intestinal lymphomas differ from gastric lymphomas in clinical features, treatment, and prognosis. They are not well characterized and the standardized concepts for their clinical diagnosis and management are absent. The aim of this rare observation is to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults.
Highlights
An Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one
Authors present an unusual case of intestinal intussusception due to a primary non-Hodgkin lymphoma (NHL) of B-cell of the terminal part of ileum
Substantial progress has been achieved in the diagnosis and treatment of gastric lymphomas in recent years [2,3] primary intestinal lymphomas are not well characterized, and standardized concepts for their clinical diagnosis and management are absent
Summary
An Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. Substantial progress has been achieved in the diagnosis and treatment of gastric lymphomas in recent years [2,3] primary intestinal lymphomas are not well characterized, and standardized concepts for their clinical diagnosis and management are absent The aim of this observation is to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults. A fourty nine-aged Moroccan patient with a medical history of repeated abdominal cramping pain especially in the right iliac fossa and a constipation of 1 year's duration, was presented to the emergency department because of a three days history of incomplete intestinal obstruction with an acute abdominal pain cramp-like localized in the right iliac fossa with no particular radiation and no aggravating factor. Ultrasonography (US) of the abdomen revealed a typical image of an intussusception in the right iliac fossa with dilated small bowel loops and no free intra-abdominal fluid. A postoperative chemotherapy (CHOP-R) stands for cyclophosphamide, hydroxydaunorubicin (Adriamycin), Oncovin (vincristine), and prednisolone combined with the monoclonal antibody rituximab was recommended but refused by the patient
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