Colo-colonic intussusception as an atypical initial presentation of inflammatory bowel disease

We report the case of a 21-year-old woman with no prior medical history who presented with lower abdominal pain, followed by diarrhoea, vomiting, and fever. Laboratory tests showed elevated inflammatory markers, while imaging with contrast-enhanced CT revealed inflammatory thickening of the right colon and features suggestive of colo-colonic intussusception. Colonoscopy confirmed intussusception of the ascending colon, which was endoscopically reduced using water immersion. Colonic biopsies revealed histological features consistent with moderately active chronic colitis, suggestive of inflammatory bowel disease (IBD). Initial treatment with corticosteroids and mesalazine led to partial clinical improvement. Persistent right-sided involvement raised suspicion of Crohn's disease, and further diagnostic evaluation is ongoing. This case highlights intussusception as a rare but possible complication of IBD, even in the absence of structural lesions, and underscores the value of conservative endoscopic management in selected patients.