Adult postoperative enteroenteric intussusception in Crohn's disease

Abstract

Postoperative jejunojejunal intussusception occurred in normal bowel of 3 patients operated on for small bowel obstruction due to Crohn's disease. Various radiologic patterns and a number of etiologic factors are described. It is concluded that this complication is prone to occur in patients having chronically dilated small bowel preoperatively and should be managed by as conservative a surgical procedure as possible.

Postoperative intussusception: a rare but critical complication in adult patients with Crohn’s disease – case report and literature review

“…Intussusception in patients with CD is very uncommon and therefore represents a challenging clinical scenario [ 6 , 12 ]. Due to the rarity of this complication and the potentially fatal consequences we performed a comprehensive review of the existing literature and identified 16 reported cases of adult intussusception (minimum age of 16) associated with CD worldwide from 1979 to the present day [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 , 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ].…”

“…In the literature symptoms ranged from light intermittent abdominal pain over a longer period of time to acute severe crampy abdominal pain, vomiting and intestinal bleeding [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 , 19 ], [ 20 ], [ 21 ], [ 22 ]. In eleven of the cases, intussusception developed postoperatively in patients with CD who had undergone surgery for complications related to the disease.…”

“…In eleven of the cases, intussusception developed postoperatively in patients with CD who had undergone surgery for complications related to the disease. The time between the operations and occurrence of the intussusception ranged from three days to several years [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ].…”

“…So far, cases describing intussusception as a postoperative complication in patients with CD have been rarely reported in the literature [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ]. Here, we present a case of jejuno–jejunal intussusception in a postoperative setting following small bowel resection and offer an overview of the literature reporting adult intussusception associated with CD.…”

Colonic Intussusception Revealing a Cecal Adenocarcinoma Associated with Silent Crohn's Disease

“…Intussusception associated with Crohn's disease is exceedingly uncommon, probably related to the presence of intestinal wall fibrosis. Of the 19 cases reported in the literature, 10 were postoperative intussusceptions; the other cases were related to gastrointestinal stromal tumors, stenosis, and fibrotic adhesion after chronic intestinal dilatation, and 5 were related to giant pseudopolyps [8][9][10][11][12][13][14][15][16][17][18][19]. Colorectal cancer is a frequent complication of longstanding Crohn's colitis that justifies endoscopic screening [20].…”