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Intussusception and colonic ischemia in portal hypertension: a case report

Timothy P Plackett1, Lisa C Coviello, Christina M Belnap

  • 1Department of Surgery, Tripler Army Medical Center, Honolulu, HI, USA.

Hawaii Medical Journal
|April 3, 2010
PubMed

Insights

Adult intussusception is rare and often requires surgery. This case highlights portal hypertension-induced colopathy as a cause of intussusception and ischemic colitis in adults.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Vascular Surgery

Background:

  • Intestinal intussusception is uncommon in adults, typically necessitating surgical resection due to neoplastic lead points.
  • Ischemic colitis is a less frequent indication for surgical removal of intussuscepted segments in adults.
  • Portal hypertension is associated with microvascular colopathy, potentially leading to intestinal intussusception.

Observation:

  • The authors report an unusual case of adult intussusception with ischemic colitis.
  • The patient had portal hypertension and was awaiting liver transplantation.
  • Portal hypertension-induced microvascular colopathy may have served as the lead point for intussusception.

Findings:

  • The colopathy of portal hypertension may predispose adults to intussusception via submucosal vascular engorgement.
  • Vascular changes in portal hypertension can impair the bowel's response to ischemic threats.
  • The intussuscepted segment in this patient was more susceptible to ischemia due to underlying vascular changes.

Implications:

  • This case suggests portal hypertension-induced colopathy as a novel lead point for adult intussusception.
  • Understanding these vascular changes is crucial for managing intussusception in patients with portal hypertension.
  • Further research may elucidate the specific mechanisms linking portal hypertension, colopathy, and intussusception in adults.

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