Spontaneous acute intussusception in a pregnant woman

Abstract

Acute intussusception in adults is rare and particularly so in pregnant women. Its incidence ranges from 0.067% to 0.0015% (Choi et al., 2005 Choi et al. (2005) [1]). The non-specific presenting symptoms may be attributed to the pregnancy itself, making the diagnosis difficult. When it happens, however, it causes considerable morbidity and mortality for the pregnant woman and the fetus. In adults, such intussusceptions are mainly secondary to an intestinal disease and frequently a tumor.We present the case of a 21-year-old pregnant woman who was diagnosed of spontaneous acute intussusception at nine weeks of gestation and therapeutic management.

Intussusception Presenting as Intestinal Obstruction in Pregnancy: A Case Report from a Tertiary Hospital in Ghana

“…In this case report the patient had an initial presentation of intermittent abdominal pain and nausea for 2 months. This is consistent with the non-specific and episodic nature of presentation in adults [16,18,22,23]. Therefore, non-specific symptoms in pregnancy must always be investigated thoroughly to identify the underlying cause for prompt medical intervention.…”

“…There is paucity of scientific data on intussusception in pregnancy globally thus making it a rare clinical occurrence [11,12,13,14,15,16]. It is a known cause of intestinal obstruction complicating pregnancy.…”

“…The treatment of choice among adults is surgical resection [11,13,16,19,20,21,22,26,28,29]. This is because it is associated with a lead point in 90% of cases, 65% of which are malignant [10,17].…”

“…Intussusception is classified into 4 types depending on the parts of the bowel involved: enteric, ileo-cecal, ileo-colic (commonest) and colo-colic [1,2,18,19,20]. Intussusception in pregnancy is rare globally [11,12,13,14,15,16]. Symptoms such as abdominal pain, nausea and vomiting may mimic obstetric symptoms, so a high index of suspicion is usually needed in pregnancy [8,18,27].…”

“…The use of radiological imaging (ultrasonography and Magnetic Resonance Imaging) in confirming diagnosis of intussusception in pregnancy cannot be overemphasized [8,11,13,14]. The treatment of choice for intussusception in adults is surgical resection, unlike in children where a more conservative approach is favored [11,13,16,19,20,21,22,26,28,29].…”