Postoperative Idiopathic Intussusception in an Adult: A Case Report

Postoperative idiopathic intussusception occurring at a site unrelated to the surgical field is extremely rare in adults. We report a case in which the condition was diagnosed early, thereby avoiding resection of the intussuscepted bowel.

The patient was a 56-year-old woman with severe motor and intellectual disabilities who had been diagnosed with cerebral palsy at 11 months of age. She underwent sigmoidopexy for recurrent sigmoid volvulus, but she developed symptoms of intestinal obstruction on POD 2. Abdominal CT revealed findings consistent with intussusception. On POD 3, a 2nd laparotomy revealed an ileocolic intussusception, and manual reduction was performed without resection of the intussuscepted bowel; a sigmoid colectomy was also performed concomitantly. Eight days after the 2nd surgery, adhesive bowel obstruction developed, and a 3rd laparotomy with adhesiolysis was performed the following day. Thereafter, her postoperative course was uneventful, and she was transferred back to her previous facility.

Postoperative idiopathic intussusception is a well-recognized postoperative condition in children, but it is extremely rare in adults, with only 10 reported cases to date, including the present case. CT is useful for diagnosis. When a target sign or a bowel-within-bowel appearance suggestive of intussusception is observed, early reduction should be considered.