Adult Ileocolic Intussusception Due to Submucosal Lipoma in Distal Ileum: A Case Report

Abstract

Intussusception in adults usually occurs secondary to a lead point which can be both benign and malignant in nature. Diagnosis of adult intussusception is rare and challenging due to its presentation with nonspecific symptoms. If not identified and treated promptly, it might lead to permanent bowel obstruction, compression of the blood supply, intestinal necrosis, bowel perforation, peritonitis, and sepsis. We report a case of a 55-year-old man with intussusception with a submucosal lipoma as the lead point. The patient presented at the emergency department with severe abdominal pain around the umbilicus with abdominal distention during the physical exam. Other complaints included vomiting, persistent nausea, and loose stools. A Computer Topography (CT) scan and exploratory laparotomy indicated ileocolic intussusception-related small bowel obstruction. Resection of the terminal ileum, caecum, and ascending colon followed by anastomosis of the remnant portion of the ileum and transverse colon done using Vertex linear cutter staplers (Healthium Medtech, India). The post operative period and follow up was uneventful. Due to its unique presentation, a diligent approach from clinicians is required when a patient presents with bowel obstruction symptoms with an unclear etiology. Although abdominal CT scan has high diagnostic value, it has low specificity in differentiating malignant, benign, or idiopathic lead points making surgical examination inevitable in most cases. This case study seeks to deepen our comprehension of adult intussusception while highlighting the need for a diligent approach to its management. We have also examined the literature to highlight key aspects of adult intussusception, challenges associated with its diagnosis, and potential management strategies.