Ileocolic Intussusception in a Woman: A Case Report and Literature Review

Abstract

Patient: Female, 65-year-old Final Diagnosis: Intussusception Symptoms: Diarrhea • fatigue Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Intussusception is a rare pathological entity in adults and remains a diagnostic challenge for clinicians, as it shares many clinical signs and symptoms with other morbid conditions (including appendicitis, abdominal hernias, colic, volvulus, and Meckel diverticulum). High clinical suspicion and use of appropriate imaging techniques are essential for early diagnosis and treatment of intussusception. Surgical intervention is the treatment of choice in cases of sustained and persistent invagination. Case Report: We present the case of a 65-year-old woman with a medical history of Crohn’s disease, diabetes mellitus type II, hypertension, and rheumatoid arthritis. She was hospitalized for diarrhea, fatigue, and anemia. Computerized tomography of the abdomen and a colonoscopy revealed telescoping of the ileum, ileocecal valve, and part of the ascending colon inside the terminal segment of the ascending colon. The antegrade ileocolic intussusception was treated by performing a right hemicolectomy. The pathologic examination of the excised intestine showed mucosal lesions compatible with Crohn’s disease, an inflammatory fibroid polyp at the terminal section of the ileum, and a low-grade appendiceal mucinous neoplasm. Conclusions: Regardless of the etiology, when the normal motility of the intestine is altered, it can lead to invagination. Although intussusception is rare, it must always be part of the differential diagnosis for a patient presenting with constant abdominal pain.

Rare Presentation of Small Bowel Obstruction Secondary to Intestinal Leiomyoma in a Patient with Crohn’s Disease

“…Crohn's has also been linked to the formation of inflammatory fibroid polyps, which are benign mesenchymal tumors of the gastrointestinal tract linked to states of chronic inflammation [15]. Several case reports have described the discovery of these polyps in patients with Crohn's disease after they resulted in intussusception of the small bowel [16][17][18][19][20]. The similarities between leiomyomas and inflammatory fibroid polyps, as they are both benign mesenchymal tumors that share many cellular markers, further support a possible association between Crohn's disease and leiomyomas.…”

Appendiceal Mucinous Neoplasms and Inflammatory Bowel Disease: Systematic Review of the Literature

“…AMNs remain a rare clinical entity in IBD patients: to this date, current evidence relies on 22 [ 18 , 19 , 21 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ] case reports and only 1 retrospective case–control study [ 14 ]. To our knowledge, this is the very first review of cases of AMN in IBD patients.…”

Intususcepción intestinal, reporte de un caso

“…Revista La U Investiga -Facultad de Ciencias de la Salud-Universidad Técnica del Norte ISSN versión digital: 2773-756X, ISSN versión impresa: 1390-910X Vol 9(2), Diciembre 2022 sonas mayores a 40 años, entre las causas identificadas (90%) se encuentra: Adenomas, endometriosis, pólipos; y el 10% restante no tiene una etiología precisa (6), puede localizarse con mayor frecuencia a nivel de yeyuno, íleon, colon ascendente, seguido del colon descendente, transverso y muy rara vez en el recto (4,7).…”

“…Cuando afecta al colon se debe descartar lesiones malignas y generalmente en intestino delgado la afección es de tipo benigno. (4,5) Se presenta el caso de una paciente con cuadro de intususcepción intestinal; de forma inicial, fue tratada como un episodio de nefrolitiasis y seudoobstrucción intestinal, al no identificar la etiología existe retraso en el diagnóstico, el uso de la tomografía simple y contrastada permitió identificar una intususcepción íleo-cólica; se resolvió por cirugía en dos ocasiones, actualmente la paciente está sin alteraciones intestinales.…”