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Periampullary adenoma leading to duodenojejunal intussusception in a young woman: A case report
Abu Bakar Bhatti1, Usman Shafique Khokhar2, Hajira Ghairat3
1Shifa College of Medicine, Islamabad, Pubjab Pakistan.
Background:
Duodenojejunal intussusception (DJI) is an uncommon clinical entity in adults, most often secondary to an underlying structural lesion. Its nonspecific gastrointestinal symptoms and rarity frequently delay diagnosis and complicate management.
Case Description:
We present the case of a 30-year-old woman with an 18-month history of right hypochondrial pain, intermittent non-bilious vomiting, and significant weight loss. Imaging and endoscopic biopsy revealed duodenojejunal intussusception secondary to a large periampullary tubulovillous adenoma. Although a transduodenal ampullectomy was initially planned, the procedure was converted to a pancreaticoduodenectomy due to the lesion's size and morphology. The postoperative course was uneventful, and the patient has remained asymptomatic and in good health for more than fifteen months after surgery.
Practical Implications:
DJI secondary to periampullary adenoma is rare but clinically significant. While endoscopic or limited surgical resection may be appropriate in select cases, pancreaticoduodenectomy offers a definitive treatment option when ampullectomy is not feasible.
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