A rare cause of adult ileocolic intussusception: ileal leiomyoma

Abstract

Intussusception is a rare condition in adulthood and, unlike in children, is usually caused by an identifiable underlying lesion, most commonly a gastrointestinal tumour. The clinical presentation is non-specific and often there are intermittent symptoms making the diagnosis difficult based solely on history and examination. Plain radiography may reveal signs of bowel obstruction, however, CT is the gold standard to diagnose and localise an intussusception in adults. We present an unusual case of adult ileocolic intussusception caused by an ileal leiomyoma. This case highlights the important radiological findings of intussusception presenting with a high-grade obstruction and discusses the potential causes which should be considered.

A rare case report: Huge ileal leiomyoma: Clinical presentation, management, and implications

“…Gastrointestinal tract leiomyomas, though uncommon, represent the most prevalent type of benign nonepithelial tumors found in the small intestine [ 4 , 6 ]. Virchow first described these tumors in 1854 [ 4 ].…”

“…Conversely, smaller lesions are often serendipitously discovered during surgical procedures, radiological examinations, or endoscopic investigations [ 1 ]. Diagnosis usually in the fifth decade of life such as our patient [ 1 , 6 ].…”

“…Nevertheless, due to the extra-luminal nature of 63% of these tumors, conventional endoscopy may encounter challenges in their assessment [ 1 ]. CT scans have demonstrated an 89.5% success rate in identifying leiomyomas, which typically appear as uniform, low-attenuation masses with a growth pattern that is primarily located within the lumen of the affected structure [ 1 , 6 ].…”

“…Magnetic resonance imaging enteroclysis and enterography are increasingly being embraced as the primary imaging methods for assessing small bowel diseases, given their superior soft tissue contrast and the capability to acquire both morphological and functional information [ 1 , 6 ]. Distinguishing Gastrointestinal Stromal Tumors (GISTs) from leiomyomas through radiological means is challenging due to overlapping characteristics and their shared anatomical origin [ 4 ].…”

Ileocecal Intussusception of the Adult Induced by the Gastrointestinal Stromal Tumor of the Ileocecal Valve - A Case Report

“…A contrasted CT scan of the abdomen and pelvis is the most sensitive and specific radiological investigation for intussusception and is the modality of choice in adults (33). The reported diagnostic accuracy of CT in adult intussusception varies but may reach 100% (34).…”