A Case of Duodeno - Duodenal Intussusception

Abstract

ABSTRACT:Intussusception is the telescoping of the full thickness of the bowel wall into the distal segment. Here we present a rare case duodenoduodenal intussusception with symptoms of recurrent abdominal pain and vomiting since two years. Surgical excision remains the treatment of choice in such cases as done in ours with the histopathology confirming the lead point to be a benign tubulovillous adenoma. Intussusception in adults presents with vague abdominal symptoms, hence the diagnosis becomes a challenge. The diagnosis is usually confirmed with the help of a CT scan or at laparotomy in the event of an emergency.

Taking the Lead: A Case Report of a Leiomyoma Causing Duodeno-Duodenal Intussusception and Review of Literature

“…4 Intussusception of the proximal small bowel, especially with the intussusceptum and intussuscipiens isolated to the duodenum, is a rare condition with only 16 reported cases in the literature occurring in 19 total patients (Table 1). 1,2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17] Typically, the anatomic position of the duodenum in the retroperitoneal space and its fixed attachments in this region serve to prevent it from being susceptible to intussusception. However, this condition can occur due to a lead point such as a mass (90% of adults cases) 18 or secondary to congenital malrotation of the bowel, where the duodenum is more mobile, allowing the intussuception to occur.…”

“…Abdominal pain, nausea, vomiting Lipoma Ko et al 13 43 Abdominal pain, melena Duplication cyst Watanabe et al 6 31 Abdominal pain Tubulovillous adenoma Naik et al 1 35…”

“…The condition results from the full-thickness invagination of a proximal portion of the bowel into the distal portion. 1 Presenting symptoms are classically described with the triad of abdominal pain, a palpable abdominal mass, and bloody stools, but all three are clinically found in less than 10% of the population with intussusception. 2 More commonly, patients present with nonspecific symptoms including intermittent abdominal pain, nausea, vomiting, and anemia.…”