A case report of an idiopathic adult ileocolic intussusception

Intussusception is a rare occurrence in adults, constituting only 1% of all cases of intestinal obstructions and 5% of all instances of intussusceptions. This condition manifests when a proximal segment of the bowel, along with its associated mesentery, telescopes into the lumen of the adjacent distal segment [1, 2]. A 69-year-old male patient presented to the emergency department with diffuse severe abdominal pain, emesis, and suppression of the passage of gases and faeces persisting for the past 3 days. Upon clinical examination, the patient presented with widespread abdominal tenderness accompanied by signs of resistance and spasms. White blood cell (WBC) count was recorded at 5.68, with polymorphonuclear neutrophils (PMNs) constituting 59%. No hernia was observed. The patient had not undergone surgery in the past. An X-ray examination of the patient revealed the presence of air-fluid levels and discernible distension within the bowel loops (Figure 1). Abdominal computed tomography (CT) scan revealed small bowel obstruction with the diagnosis of ileocolic intussusception (Figure 2). Subsequently, the patient underwent segmental small bowel resection.
Intraoperative findings established the diagnosis of ileocolic intussusception (Figure 3). A segmental small bowel resection with simultaneous anastomosis was performed. The histopathological examination revealed focal necrotic changes and haemorrhagic areas within the affected bowel segment. Notably, no evidence of neoplastic transformation was identified. Following surgery, the patient remained hospitalised for 7 days with no major postoperative complications and was then discharged. Intussusception, defined as the telescoping of one portion of the intestine into another, is a primary cause of bowel obstruction in infants; its occurrence in adults, particularly the elderly, is rare. Adult intussusception manifests in 3 distinct types: enteric, ileo-colic, and colo-colic [1]. Clinical indicators of mechanically induced intestinal blockage encompass nausea, vomiting, and abdominal cramping. Diagnosis of adult intussusception necessitates a heightened clinical suspicion, a comprehensive medical history review, and a thorough physical examination. The considerable heterogeneity in both clinical presentation and imaging findings poses challenges for the preoperative identification of intussusception. Reijnen et al. reported a relatively high preoperative diagnosis rate at 50%, while Eisen et al....


Pełna treść artykułu...