Laparoscopic Small Bowel Resection for Adult Ileoileal Intussusception Secondary To Inflammatory Fibroid Polyp

Chebrolu Gowthami, Dr. Pari Muthukumar, Dr. Jayanth Leo, Dr. Vishwanath M Pai. Sri Ramachandra University

Adult Intussusception is a very rare condition accounting for 1% of all adult bowel obstruction and 5% of all cases of intussusception. Adult Intussusception is almost always due to a demonstrable underlying pathology primarily caused by tumors. 80% of the tumors associated with small bowel intussusception are benign. Inflammatory fibroid polyps are rare, benign, polypoidal lesions originating in the submucosa of the gastrointestinal tract most commonly seen in the stomach. They seldom are found to be lead point lesions for cases of intussusception.

We report an unusual case of Adult Ileoileal Intussusception secondary to an Inflammatory Fibroid Polyp.

A 34 year old female presented to the emergency department with chief complaints of acute abdominal pain associated with vomiting for a duration of 10 days and constipation for the last 2 days. She had no known comorbidities and gave no history of previous abdominal surgeries. At presentation, she was tachycardiac with upper abdominal distension, diffuse abdominal tenderness and hyperactive bowel sounds. All her baseline investigations were normal. Xray abdomen showed multiple air fluid level. CECT abdomen revealed an ileoileal intussusception in the proximal ileum. Over diagnostic laparoscopy, ileoileal intussusception was confirmed following which a laparoscopic resection and anastomosis of small bowel intussusception was performed. The specimen was sent for histopathological study and immunohistochemistry was done where the features favoured the aetiology of intussusception to be an inflammatory fibroid polyp.

This case report highlights the fact that intussusception is an extremely rare cause of adult intestinal obstruction and inflammatory fibroid polyp is one of the least common causes of the same. Given the risks of underlying malignancy and vascular compromise, once adult intussusception is diagnosed, the treatment is operative resection.

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