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Intestinal intussusception-not just for kids
Paul Lynch1, Gerard Feeney1, Nisar Ali1
1Department of Surgery, University Hospital Limerick, Limerick V94 F858, Ireland.
Insights
Adult intussusception, though rare, often indicates a tumor. This case highlights an ileal myxoma causing a rare, extensive intussusception in a 56-year-old man, stressing prompt diagnosis.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Imaging
Background:
- Intussusception is rare in adults, unlike in children.
- In adults, it often signifies an underlying malignancy.
- Prompt diagnosis and management are crucial for favorable outcomes.
Observation:
- A 56-year-old male presented with severe, worsening left lower abdominal pain.
- Computed tomography revealed a long-segment intussusception involving the distal small bowel, colon, and mesentery.
- The patient underwent a right hemicolectomy.
Findings:
- Histopathology confirmed an ileal myxoma as the lead point of the intussusception.
- This rare tumor initiated the extensive bowel telescoping.
- The surgical intervention was successful.
Implications:
- This case underscores the importance of investigating atypical abdominal pain in adults.
- It highlights the diagnostic value of advanced imaging like CT scans.
- Early detection of lead-point tumors in adult intussusception improves patient prognosis.
Abstract:
Intussusception is a phenomenon commonly associated with the paediatric population. In adults, intussusception is frequently a result of a neoplastic process. We present the case of a 56-year-old gentleman who was diagnosed to the local Emergency Department with a 4-day history of worsening severe, left sided lower abdominal pain. The pain was colicky in nature. Computed tomography identified a long-segment intussusception involving distal small bowel, caecum, ascending colon, the entirety of transverse colon and its associated mesentery. The patient proceeded to theatre where a laparotomy and right hemicolectomy was performed. Histopathological analysis of the specimen identified an ileal myxoma as the lead-point of the intussusception. This report emphasises the value of prompt investigation in atypical clinical presentations.
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