Ileocolic intussusception in adults – An unusual entity

Abstract text (incl. references and figure legends)

Introduction

Intussusception is defined as the invagination of a segment of the intestine over the lumen of the immediately adjacent segment, more common in children. In adults, almost all cases are malignant neoplasms involving the ileocecal valve. Diagnosis is challenging given nonspecific symptomatology. Abdomino-pelvic X-ray and computed tomography (CT) are useful. Almost 70-90% of cases in adults require surgery as definitive treatment.

Material and Methods

Case report and presentation of casuistry of the last 10 years in our emergency department.

Results

A 38-year-old woman was admitted to the emergency department with severe diffuse abdominal pain associated with blood stool that started 2 hours before. She reports the onset of abdominal pain for 7 months. The abdomen was diffusely painful. Ultrasonography and CT report aspects were suggestive of ileocolic invagination. We confirmed intraoperatively invagination of small intestine and a Meckel"s diverticulum into the cecum extending to the proximal transverse colon. A right hemicolectomy with primary anastomosis was performed. The postoperative had no complications. Histology was negative for neoplasia.

Conclusion

Intestinal intussusception in adults is rare and has nonspecific symptomatology. It is a surgical emergency associated with high mortality rates in case of late treatment. In our department in the past 10 years, only a few cases were diagnosed, as reported.

References

Moniakis A.A. et al: Ileocolic intussusception: A case report and literature review, Am J Case Rep, 2021; 22:e933341 Muniba M. et al: A rare case of idiopathic ileocolic intussusception in an adult; Medicine and pharmacy reports, Vol. 94/No. 4 /2021: 516-520 Lief K et al: Diagnostic challenge of the non-specific presentation of adult intussusception BMJ Case, Rep 2019;12:e229931 Amol N. Wagh, et al: A rare case report of large B cell lymphoma in adult presentation as intussusception, Clinics and Practice 2020;volume 10:1292l.

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