Gastrogastric intussusception in adults: a case report with review of the literature

Abstract

Intussusception of the gastrointestinal viscera is rarely encountered in adult patients and is frequently associated with a polypoidal lead point, which is often malignant. We would like to present the case of a 68-year-old male with a history of decompensated liver disease and multiple medical comorbidities, who was discovered to have an incidental gastrogastric intussusception on CT. No polypoidal lead point was seen and we believe this to be the first case of its kind to be described. We suggest that distortions in the patient’s visceral and vascular anatomy and raised intra-abdominal pressure resulting from concomitant ascites, hiatus hernia, portal hypertension and oesophageal varices have provided an alternative mechanism for a gastrogastric intussusception to develop.

Epigastric discomfort in a 91-year-old woman

“…As similar to our case, there is the only one case report which described the absence of a polypoidal lead point in the patient who was diagnosed with the gastric intussusception. 3 One significant difference between the case which we have described and the previous case is that our patient does not have the complications associated with portal hypertension such…”

Gastrogastric intussusception in the setting of a small bowel obstruction

“…Very few reported cases have a benign etiology. 1 Non‐malignant ascites have been implicated as an etiology of gastrogastric intussusception in some reports during 2018–2020. 1 , 3 In 2019, an 82‐year‐old patient had a severe gastrogastric intussusception with a gastric volvulus and a hiatal hernia.…”

“…According to Behrooz et al, “the earliest known description of intussusception was made by the Dutch physician Paul Barbette in 1674, with the first successful manual reduction of an intussusception being performed by Sir Jonathan Hutchinson in 1871 in a 2‐year‐old girl.” 1 Adult patients comprise 5% of all intussusceptions with only 2 to 3 cases per million per year. Of those, only 10% of adult intussusceptions involve the stomach.…”

“…From 1950 to 2017, there have been only 9 case reports of gastrogastric intussusception, with all cases attributed to neoplasms. 1 Recently, there have been a few reported cases caused by ascites or hiatal hernias. 2 , 3 Here, we present a case of a 65‐year‐old male found to have a gastrogastric intussusception in the setting of a small bowel obstruction with no evidence of neoplasm confirmed by biopsy.…”

Gastro-gastric intussusception in the setting of a neuroendocrine tumor: A case report

“…However, intussusception involving the proximal gastrointestinal tract such as the stomach is exceedingly rare. A recent literature review identified only 10 instances of gastro-gastric intussusception since 1950, all of which were associated with a mass, either benign or malignant, functioning as a lead point[4-13] (Table 1).…”