A Rare Presentation of Adult Intussusception

Intussusception occurs when one segment of the intestine telescopes into another, potentially causing bowel obstruction and impaired blood flow. While more commonly observed in children, adults may also be affected. In most adult cases, an underlying cause such as a neoplasm, adhesion, or inflammatory lesion is identified. However, rare cases present without a clear precipitating factor. We report a case of a 40-year-old male with a history of constipation and internal hemorrhoids who presented with diffuse abdominal pain and multiple episodes of non-bloody, non-bilious vomiting. He denied recent illness, travel, or family history of gastrointestinal disease. Physical examination revealed diffuse tenderness without peritoneal signs, and laboratory results were unremarkable. A non-contrast CT scan of the abdomen and pelvis revealed an enteroenteric intussusception without evidence of bowel obstruction, mass, or ischemia. Given the patient's stable clinical status and lack of high-risk features, conservative management was initiated. This included intravenous fluid hydration, bowel rest (NPO), antiemetic therapy, and close monitoring with serial abdominal examinations. A small bowel follow-through with oral contrast later confirmed spontaneous reduction of the intussusception. The patient's symptoms resolved, and he was gradually reintroduced to oral intake. He remained stable throughout hospitalization and was discharged in good condition with outpatient follow-up arranged. This case demonstrates that conservative treatment may be appropriate for adult intussusception in select cases, particularly when there are no signs of obstruction, ischemia, or a clear lead point. Timely imaging and close clinical assessment are critical to guide management and avoid unnecessary surgical intervention.