WTP7.8 Adult Bowel Intussusception: A Case Report and new insights

Abstract

Abstract Introduction Intussusception in adults is rare and constitutes 1-5% of small bowel obstructions. This rarity along with atypical presentation make diagnosis difficult, sometimes delayed and makes cross-sectional imaging mandatory for correct management. Prompt diagnosis and treatment are essential to prevent serious complications like perforation, peritonitis etc. Usually, lead points have been thought to be caused by neoplastic polyps but recently, non-malignant causes (lipomas or nodal masses) are coming to the forefront. Postoperative histology review is important to plan for further management. Here we present an adult patient with intussusception who needed surgical intervention but no post procedure treatment. Case report Our 78- year-old patient was admitted with sudden onset severe generalised abdominal pain for a day. Examination revealed a soft abdomen with a tender mass palpable in her right lower abdomen. CTAP revealed long segment ileocolic intussusception with a 3cm lipoma as the lead point. She underwent a laparotomy where oedematous bowel with irreducible intussusception and possible ischaemia were found; a right hemicolectomy was carried out. Histology revealed the intussuscipiens to be a lipoma. She made an uneventful recovery. Discussion It is important to consider intussusception in the differential diagnosis in adult patients with abdominal pain even in absence of typical obstructive symptoms. Adult cases are usually associated with neoplasm but there is increasing evidence of nonmalignant causes such as benign polyps, nodal masses or lipomas which act as the lead point in adult intussusception. Postoperative histology review is important to plan further management.