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Adult ileo cecal intussusception as a manifestation of colon carcinoma: A case report
Abdihakim Elmi Abdishakur1, Mohamed Amiin Adan Ahmed2
1Department of General Surgery, Somali Sudanese Specialized Hospital, Mogadishu 274149, Banadir, Somalia. xakiimcilmi@hotmail.com.
Insights
Adult intussusception, though rare, necessitates consideration in cases of intestinal obstruction. Prompt surgical intervention is crucial for effective management, especially when malignancy is suspected.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Intussusception, the telescoping of one bowel segment into another, is the leading cause of intestinal obstruction in children.
- In adults, intussusception is rare, comprising 1% of intestinal obstructions and 5% of all intussusception cases, with malignancy as the frequent etiology.
- Historically diagnosed intraoperatively, advances in computed tomography (CT) imaging have enhanced in-vivo recognition of intussusception.
Observation:
- A 45-year-old female presented with acute abdominal pain, distension, vomiting, and constipation, coupled with significant weight loss over two months.
- Imaging revealed ileocecal intussusception attributed to a colorectal mass in the cecum and ascending colon.
- The patient underwent surgical management via extended right hemicolectomy.
Findings:
- Adult intussusception, particularly when caused by a colorectal mass, presents with severe abdominal symptoms.
- Computed tomography is instrumental in diagnosing intussusception in adults, identifying the underlying cause.
- Surgical resection is the definitive treatment for intussusception secondary to malignancy.
Implications:
- Heightened clinical suspicion for intussusception in adults with obstructive symptoms is warranted.
- Early diagnosis through advanced imaging can facilitate timely surgical intervention.
- Management of adult intussusception requires addressing the underlying etiology, often a neoplastic process, necessitating surgical management.
Background:
Intussusception is the invagination of a segment of the bowel into an adjacent segment. It is the most common cause of intestinal obstruction in children, but in adults, it is rare, accounting for 1% of all intestinal obstructions and 5% of all intussusceptions, with malignancy being the most common cause. In the past, it was typically diagnosed intraoperatively. However, with the availability of computed tomography for abdominal imaging, recognizing the condition's signs has become crucial. Surgical intervention is essential for managing neoplastic cases and their complications.
Case Summary:
A 45-year-old female presented with severe abdominal pain encompassing her entire abdomen, abdominal distension, vomiting, and persistent constipation. Over the past two months, she has also experienced considerable weight loss. After an initial history review, examination, and imaging investigations, the patient was diagnosed with ileo cecal intussusception resulting from a colo rectal mass located in the cecum and ascending colon. This condition was surgically managed through an extended right hemi colectomy.
Conclusion:
Intussusception is uncommon in adults, but it should be considered in patients with intestinal obstruction. Surgical intervention is essential.
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