Navigating Diagnostic Challenges: An Uncommon Case of Jejunal Leiomyoma With Intussusception and Acute...

This case report aims to describe an uncommon occurrence of jejunal leiomyomas, highlighting the clinical presentations, diagnostic challenges and therapeutic interventions. A 48-year-old male patient with a history of a jejuno-jejunal intussusception treated conservatively presented two years later with dark, maroon-colored stools and a hemoglobin of 6.8 g/L. Gastrointestinal upper endoscopy and colonoscopy showed no alterations that could justify the event. Endoscopic capsule revealed an ulcerated subepithelial lesion in the proximal jejunum. Abdominal CT scan indicated a 4.6-cm mesenchymal lesion (likely gastrointestinal stromal tumor (GIST) or leiomyoma) in the jejunum. It was chosen to proceed with enterectomy due to the severity of the bleeding. At the time of the operation, the histopathological characteristics of the jejunal lesion were not definitively known but histopathology confirmed a jejunal leiomyoma. This case underscores the necessity of considering jejunal leiomyoma as a cause of acute gastrointestinal bleeding and the importance of a thorough investigation into potential underlying etiologies in adult intussusception cases. Furthermore, this case illustrates the diagnostic complexities associated with jejunal leiomyomas.