Uncommon Ileo-Cecal Intussusception in Adults: A Case Report of Diagnosis and Management.

Abstract

BACKGROUND This report describes the case of a 36-year-old man presenting with severe abdominal pain and small-bowel obstruction due to idiopathic ileo-cecal intussusception. Intussusception refers to the telescoping or folding of a segment of bowel into the section distal to it. It is one of the main differentials of small-bowel obstruction in the pediatric population, but remains exceedingly rare in adults. Intussusception in adults is generally associated with organic masses of the digestive tract, especially tumors, which act as lead points that drag the proximal bowel into a more distal segment. It is extremely uncommon to find intussusception in an adult patient with no obvious underlying bowel pathology. CASE REPORT We report a case of ileo-cecal intussusception in an adult patient that yielded no underlying bowel anomaly on surgical exploration and pathology. The patient, a 36-year-old man, presented with severe abdominal pain and was diagnosed with intussusception through computed tomography (CT) scanning. Surgical resection and anastomoses of the bowel were subsequently performed when medical therapy failed. The patient experienced diarrhea and vitamin-deficient neuropathy a month after surgery, which was diagnosed as short bowel syndrome, and which resolved with appropriate medical care. CONCLUSIONS Intussusception, while rare in adult patients, is possible even without underlying bowel disease. However, a thorough surgical exploration and proper pathology analysis are essential to confidently exclude other gut anomalies. Clinicians should be aware of possible complications like short bowel syndrome if the surgical approach is used and a significant amount of intestine is resected.