Adult idiopathic ileocolic intussusception: A case report

Masaki Bannai ； Antonio Pais

《International Journal of Case Reports and Images (IJCRI)》 7卷9期 (2016/09) Pp. ii+566-569

https://doi.org/10.5348/ijcri-2016101-CR-10689

摘要

Introduction: Intussusception is a rare cause of acute abdomen in adults. Traditionally, management of adult intussusception has mandated surgical interventions due to a high incidence of malignant lesion resulting in intussusception. However, recent literature challenges the traditional view of mandatory surgical interventions for all adult intussusceptions due to an increasing number of benign and idiopathic cases. These benign and idiopathic cases of adult intussusceptions are more readily identified partly due to recent widespread use of computed tomography imaging technique. With the growing number of idiopathic cases, recent literature recommends against the traditional mandatory operative exploration of all adult intussusceptions, only advocating surgical interventions for selected cases. Case Report: A 38-year-old female presented with an acute onset of severe right-sided abdominal pain with associated nausea, vomiting and rectal bleeding to our emergency department. Her computed tomography scan of abdomen and pelvis showed an ileocolic intussusception which had advanced to the level of the hepatic flexure without any mass lesion. The patient underwent an emergency ileocecal resection with side-toside anastomosis of terminal ileum to ascending colon. Conclusion: This case report adds to literature with evaluation of the rare form of adult intussusception without a lead point. There may be a role for a conservative management approach of subtypes with high incidence of primary malignant lesions in the absence of a lead point on a CT scan especially among young patients without any concerning features.

關鍵字

Adult idiopathic ileocolic intussusception ； Rectal bleeding