Jejuno-jejunal intussusception secondary to recurrent/metastatic melanoma

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Imaging

Background:

• Intussusception is infrequent in adults, typically secondary to an underlying neoplasm.
• Small bowel obstruction (SBO) is common in adults, but intussusception is an uncommon cause.

Observation:

• A 55-year-old woman with a history of melanoma presented with symptoms of SBO, including abdominal pain and melena.
• Initial endoscopic evaluations were normal, but subsequent CT imaging revealed a small bowel intussusception.
• The patient underwent surgery where the intussusception was reduced, revealing a mass.

Findings:

• Pathology confirmed a 5.5 cm metastatic melanoma as the cause of the intussusception.
• The patient required oncologic resection and primary anastomosis.
• She remained in remission for eighteen months post-operatively.

Implications:

• Metastatic melanoma can present as intussusception, a rare but critical diagnosis in patients with a history of melanoma and SBO.
• Early consideration of intussusception in patients with SBO and a history of melanoma is crucial.
• Prompt oncologic resection can optimize outcomes for patients with intussusception secondary to metastatic melanoma.