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Published on: October 22, 2013
[Intestinal intussusception in adults, atypical and potentially dramatic]
J Pudzeis1, C Henrard1, N Meurisse1
1Service de Chirurgie abdominale, sénologique, endocrine et Transplantation, CHU Liège, Belgique.
Insights
Adult intussusception, though rare, can be caused by lymphoma. This case highlights ileal intussusception in a 67-year-old due to plasmablastic lymphoma, requiring surgical intervention.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Pathology
Background:
- Intestinal intussusception is predominantly a pediatric condition, with adult cases being infrequent.
- Adult intussusception often presents with non-specific symptoms, leading to diagnostic challenges.
Observation:
- A 67-year-old male presented with recurrent, severe abdominal pain.
- Initial comprehensive assessments were inconclusive.
- Enteric CT scan revealed ileal-ileal intussusception.
Findings:
- The intussusception was found to be caused by a monoclonal plasmablastic lymphoma.
- This condition led to a partial obstruction of the small intestine.
- Exploratory laparotomy was performed due to the irreducible nature of the intussusception.
Implications:
- This case underscores the importance of considering intussusception in adults presenting with unexplained abdominal pain.
- Plasmablastic lymphoma should be included in the differential diagnosis of adult intussusception.
- Surgical resection may be necessary for irreducible adult intussusception, particularly when associated with malignancy.
Abstract:
Intestinal intussusception is essentially a pediatric pathology that remains rare in adults. We report the case of a 67-year-old patient hospitalized for persistent painful abdominal attacks despite the completion of an almost exhaustive assessment. An entero-scanner will finally show the presence of ileal-ileal intussusception, which is the site of a monoclonal plasmablastic lymphoma and responsible for an upstream sub-obstruction. This condition will require an exploratory laparotomy. As often in this pathology of the adult, the irreducible character will justify the realization of a small resection of the incriminated segment.
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