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Rare cause of intussusception in a young male with a new possible etiology - A case report
Arti Anand1, Ashutosh Nagpal1, Ashish Arsia2
1Lady Hardinge Medical College, New Delhi 110001, India.
Introduction:
Inflammatory Fibroid Polyp (IFP) is a rare benign tumor of the gastrointestinal tract with no proven etiology. IFPs may sometimes produce complications like intussusception when present in the small bowel. This is a case report of a patient with an established diagnosis of inflammatory fibroid polyp with abdominal tuberculosis. Such co-existence has not been reported yet in literature.
Case Presentation:
In this case report we see a 22-year-old gentleman presenting with a 10-day history of generalized abdominal pain which then progressed to obstipation. X-ray abdomen findings were consistent with small bowel obstruction. Computerized tomography imaging revealed the presence of a Jejuno-ileal intussusception. The patient was taken up for emergency laparotomy and he underwent resection of the intussuscepted segment with a polyp found as the lead point accompanied by dense bowel adhesions. Histopathological examination revealed it to be a Benign Fibro epithelial Polyp. Histopathology of the resected bowel segment and mesenteric lymph node also revealed findings confirmatory of abdominal tuberculosis. This may be a possible new etiology of the fibro epithelial polyp and this co-existence has never been reported before in literature.
Conclusion:
Tuberculosis may be a possible inciting factor for the development of benign fibro epithelial polyp in the small bowel which may in turn lead to complications such as small bowel intussusception warranting need for surgical intervention.
Insights
Tuberculosis may cause inflammatory fibroid polyps (IFPs) in the small bowel, leading to complications like intussusception. This rare case highlights a potential new etiology for IFPs, emphasizing the need for surgical intervention in such instances.
Area of Science:
- Gastroenterology
- Pathology
- Infectious Diseases
Background:
- Inflammatory fibroid polyps (IFPs) are rare, benign gastrointestinal tumors with unknown causes.
- IFPs in the small bowel can lead to serious complications such as intussusception.
- This case report details a unique co-existence of IFP and abdominal tuberculosis.
Observation:
- A 22-year-old male presented with abdominal pain and obstipation, indicative of small bowel obstruction.
- Imaging revealed jejuno-ileal intussusception, with a polyp identified as the lead point during emergency laparotomy.
- Histopathology confirmed a benign fibroepithelial polyp and abdominal tuberculosis in the resected segment and lymph nodes.
Findings:
- The co-existence of inflammatory fibroid polyp and abdominal tuberculosis has not been previously reported in medical literature.
- Histopathological findings suggest tuberculosis as a potential inciting factor for the development of fibroepithelial polyps.
- The polyp acted as the lead point for intussusception, necessitating surgical resection.
Implications:
- Tuberculosis may represent a novel etiology for the development of benign fibroepithelial polyps in the small intestine.
- This association underscores the importance of considering infectious causes in the etiology of gastrointestinal polyps.
- Early diagnosis and surgical intervention are crucial for managing complications like intussusception arising from these polyps.
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