Adult intussusception: a case report

Introduction: Intussusception is a recognised cause of bowel obstruction and is significantly more common in paediatric patients. Adult intussusception is rare and requires a predisposing factor in the vast majority of patients and this may include a benign lesion, a malignant lesion or bowel wall abnormality such as inflammatory bowel disease.

Presentation of case: We present the case of a patient presenting with upper abdominal pain, nausea, vomiting and weakness. The patient had ongoing mild intermittent abdominal pain for months which was investigated with an oesophagogastroduodenoscopy (OGD) that showed gastritis. There were features of peritonism on clinical examination and this was associated with raised inflammatory markers. A Computed Tomography (CT) scan showed telescoping of the ileum with proximal bowel distension suggesting bowel obstruction. The patient underwent emergency surgical resection. Histopathology assessment did not identify a causative factor for the intussusception.

Discussion: We present a case of idiopathic entero-enteric intussusception in an adult which is not commonly seen. Clinical history of chronic intermittent abdominal pain and CT abdomen are helpful in establishing the diagnosis. Despite that conservative approach is described in the literature, surgery continues to be the only option in patients who are unstable and show signs of peritonitis.

Conclusion: Adult intussusception is not a common condition and can be difficult to diagnose. Patients with intussusception may report a relatively long period of intermittent abdominal pain that worsen acutely due to complete obstruction. CT is the most useful investigative modality to confirm the diagnosis of intussusception.