Covert gastroduodenal intussusception: a case report

Area of Science:

• Gastroenterology
• Radiology
• Geriatric Medicine

Background:

• Gastroduodenal intussusception is an exceedingly rare condition in adults, often presenting with significant symptoms.
• Prompt diagnosis and appropriate management are crucial, especially in the elderly population.

Observation:

• A 99-year-old female presented with a 3-day history of upper abdominal pain radiating to the back and right shoulder.
• Physical examination revealed mild epigastric and right hypochondrial tenderness.
• Abdominal CT scan diagnosed a small gastroduodenal intussusception without clear obstructive signs or an identifiable leading point.

Findings:

• Despite the rare diagnosis, the patient exhibited no obstructive signs or symptoms.
• The absence of an obvious leading point on imaging complicated the diagnostic picture.
• A conservative management strategy was chosen due to patient and family preference against gastroscopy.

Implications:

• This case highlights the possibility of asymptomatic or minimally symptomatic gastroduodenal intussusception in the very elderly.
• It underscores the importance of advanced imaging like CT scans in diagnosing rare gastrointestinal conditions.
• The successful conservative management suggests this approach may be viable in select elderly patients with stable, non-obstructive gastroduodenal intussusception.