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Iatrogenic Intussusception Due to Gossypiboma Presenting as Acute Intestinal Obstruction to a Tertiary Care Emergency
Pranjul Sharma1, Himanshi Baid1, Harindra Sandhu2
1Emergency Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND.
Abstract:
Intussusception, typically a pediatric condition, is rare in adults and poses a diagnostic challenge in emergency settings due to its varied presentations. We present a case of a 48-year-old female with a history of recurrent abdominal pain after cholecystectomy (done two years back), who presented with an acute onset of colicky abdominal pain, vomiting, and obstipation. Initial evaluation revealed signs of intestinal obstruction and metabolic acidosis. Imaging confirmed sigmoid colo-colic intussusception with a suspected mass lesion as the lead point, later identified intraoperatively as a retained surgical mop. Despite emergent surgical intervention with bowel resection and stoma formation, the patient's clinical course was complicated by septic shock, acute kidney injury, and refractory metabolic acidosis, leading to a fatal outcome. Adult intussusception remains a diagnostic and therapeutic challenge, often necessitating prompt surgical intervention, yet the outcome can be poor, especially in cases with significant intra-abdominal pathology and delayed presentation.
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