Adult ileocecal intussusception induced by adenomatous ileal polyp: case report and literature review

Abstract

Intussusception is a rare cause of bowel obstruction in adults, and has generally an organic etiology. However, adenomatous polyp of the small bowel is an uncommon etiology. Moreover, there’s a great difference with childhood intussusception in its presentation, etiology and management. We describe herein a case of adult ileocecal intussusception due to an adenomatous ileal polyp with a preoperative diagnosis made on computed tomography. We performed a right hemicolectomy, without attempting to reduce the intussusception, and an end-to-end ileotransverse anastomosis. The pathological examination of the surgical specimen revealed an adenomatous polyp with a high grade dysplasia on the terminal ileum, being the cause of the ileocecal intussusception.

Adult Mid Ileo-Ileal Intussusception Secondary to Inflammatory Myofibroblastic Tumor (IMT): A Case Report and Literature Review

“…Pre-operative diagnosis of adult intussusception is difficult because of varying clinical signs and symptoms. Computed tomography (CT) scan is the most sensitive modality for the diagnosis of intussusception with 58-100% accuracy [1]. Abdominal ultrasonography reported to have 35% accuracy, is still considered useful for diagnosis in both resourceful and low resource countries [7].…”

“…Adult intussusception is a rare clinical condition that accounts for only 5% of all cases of intussusception and 1% of the cases of intestinal obstruction [1,2]. The pediatric population always shows primary or benign intussusception, whereas the adult variant always occurs in the background of some organic lesion.…”

A rare case of bowel intussusception due to adenocarcinomatous polyp in a 14 year-old child: case report

“…A study conducted in 1984 showed a 12-year-old girl with primary small bowel adenocarcinoma but there was no polyp and it did not cause an intussusception of the small bowel [10]. Another study reviewed an ileocecal intussusception that appeared in a 50-year-old man and the histologic report confirmed high-grade dysplasia not adenocarcinoma [11].…”

Transient Sigmoidorectal Intussusception Simulating Submucosal Tumor in a Healthy Woman: An Unusual Case and Review of the Literature

“…Intussusception in adults is rare, although being common in children; it accounts for 1% of patients having bowel obstruction, and 5-10% of all intussusception occasions; and approximately 90% of adults with intussusception have an underlying lesion, almost half of which are malignant [6]. Intussusception results from the change of normal peristalsis by a lesion in the gut wall that induces invagination; it is demarcated as the invagination of one segment of the bowel into an immediately adjacent segment.…”

“…Likewise, the exact mechanism of sigmoidorectal intussusception in our case is unidentified because there was neither a lesion in the colon nor an irritant in its lumen to serve as lead point that could change the normal peristalsis pattern and initiate the invagination leading to intussusception. In this respect, sigmoidorectal intussusception, a distinctly very rare condition in adult patients associated with a pathological cause, acts as the lead point in the mechanism of intussusception; benign or malignant lesions predominantly managed by surgical resection; and when the colon is involved, surgical resection is recommended owing to the high risk of underlying malignant tumor, perforation and spillage [6,9].The peristalsis pushes the lesion, which functions as lead point, and leads to the intussusception of sigmoid in the rectal cavity.…”