Intussusception in pregnancy: report of a case

Abstract

A 35 year old Gravida 10 Para 8+1 (7 alive) presented with three months amenorrhoea and acute onset of abdominal pain with vomiting and constipation. Clinical and sonological evaluations were supportive of an intussusception occurring in a first trimester twin pregnancy. She was resuscitated and had ileal resection with end to end anastomosis. She subsequently had home delivery at term with resultant perinatal death of the second twin and severe anaemia. As intestinal obstruction is a rare but serious event in pregnancy, the importance of high index of suspicion in the evaluation of abdominal pain in pregnancy is emphasised. The usefulness of ultrasound in the early diagnosis of intussusception in pregnancy is discussed.

Strangulating Ileocolic Intussusception in Pregnancy

“…In addition, it eliminates the hazards of radiation. We agree with the view of Abdul et al [2] that ultrasonography should be recommended as part of the investigation protocol for all suspected cases of intestinal obstruction in pregnancy. Maternal and fetal morbidities from intestinal obstruction are greater in the third trimester or when strangulation or perforation occurs.…”

“…About 60 % cases are caused by adhesions, 25 % are the result of volvulus, and less than 5 % are because of intussusception [2][3][4]. Intussusception (invagination of one part of bowel into another) is primarily a disease of infants and children with no organic lesion; however, in adults, it is usually associated with a lead point as polyp in the present case.…”

“…The risk of bowel obstruction is the highest during rapid changes in uterine size in relationship to a previous scar or bowel (a) in the early portion of the second trimester when the uterus changes from being a pelvic to an abdominal organ, (b) in the late third trimester when the fetal head descends into the pelvis, and (c) in the puerperium [1][2][3][4].…”

Intussusception in a 20 weeks pregnant woman: a case report

“…These can be of many different aetiologies including carcinoma of the colon, meckel’s diverticulum, submucous lipomas, Peutz Jegher polyps, leiomyomas, neurofibromas, adenomas, heterotopic pancreatic tissue and many others [ 5 , 6 ]. The literature differs between small bowel [ 3 ] and ileo-colic [ 7 ] as the most common types of intussusception. They agree that small bowel intussusception is more likely to have a benign lesion at the apex whereas ileo-colic or colo-colic are more likely to have malignant ones [ 2 , 3 , 7 ].The imaging modalities of choice in adults are the CT/ MRI scan and the double contrast enema [ 1 , 2 ].…”

“…The literature differs between small bowel [ 3 ] and ileo-colic [ 7 ] as the most common types of intussusception. They agree that small bowel intussusception is more likely to have a benign lesion at the apex whereas ileo-colic or colo-colic are more likely to have malignant ones [ 2 , 3 , 7 ].The imaging modalities of choice in adults are the CT/ MRI scan and the double contrast enema [ 1 , 2 ]. Their diagnostic yields are 52%-58% and 41%-73%, respectively.…”