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Published on: March 24, 2023
Small bowel intussusception causing a postoperative bowel obstruction following laparoscopic low anterior resection
Ahmad S Hussain1, Rajalakshmi Warrier1, Harry T Papaconstantinou1
1Department of Surgery (Hussain, Warrier, Papaconstantinou), Section of Colon and Rectal Surgery (Warrier), Scott & White Memorial Hospital and Clinic and Texas A&M University System Health Science Center College of Medicine, Temple, TX.
Abstract:
Adult intussusception usually presents with nonspecific symptoms such as abdominal pain, bloating, nausea, vomiting, and a change in bowel habits. Although postoperative intussusception has been described in the pediatric population, there has been little description of it in the adult population. Postoperative intussusception has unique challenges, as hydrostatic reduction may compromise bowel anastomoses. Surgery is the universal treatment in these patients. In adults, delay in diagnosis and definitive treatment may be a direct result of common symptomatology between postoperative ileus and intussusception. We present a case of an adult patient who underwent laparoscopic low anterior resection for rectal cancer and developed a small bowel intussusception causing obstruction requiring surgery. To our knowledge, this is the first report of a small bowel intussusception masquerading as a postoperative ileus in an adult. While most postoperative delayed bowel function is attributed to ileus, abscess formation, or anastomotic leak, other uncommon etiologies, including intussusception, may occur and are important to include in the differential diagnosis.
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