Abdominal pain is a common presentation to the emergency department (ED) and the differential diagnoses is broad. Intussusception is more common in children, with only 5% of cases reported in adults. 80%–90% of adult intussusception is due to a well-defined lesion resulting in a lead point, whereas in children, most cases are idiopathic. The most common site of involvement in adults is the small bowel. Treatment in adults is generally operative management whereas in children, a more conservative approach is taken with non-operative reduction. We present a case of a 54-year-old woman who presented to our ED with severe abdominal pain and vomiting. CT of the abdomen revealed a jejunojejunal intussusception. The patient had an urgent laparoscopy and small bowel resection of the intussusception segment was performed. Histopathological examination of the resected specimen found no pathologic lead point and, therefore, the intussusception was determined to be idiopathic.

Background Abdominal pain is a common presentation to the emergency department (ED) and the differential diagnoses is broad. Intussusception is a more common diagnosis in children, with only 5% of cases reported in adults. 80–90% of adult intussusception is due to a well-defined lesion resulting in a lead point, whereas in children, most cases are idiopathic. Adult intussusception is also more commonly associated with malignancy, compared to children. In adults, malignancy is more common in intussusception involving the large bowel compared to intussusception in the small bowel. Case presentation We present a case of a 54-year-old lady who presented to our ED with abdominal pain and vomiting. She had multiple abdominal surgeries in the past. On examination, she had epigastric and peri-umblical tenderness. In view of her persistent abdominal pain that was refractory to analgesia, she had computed tomography (CT) of the abdomen which revealed a jejuno-jejunal intussusception and proximal small bowel obstruction. The patient had an urgent laparoscopy and small bowel resection of the intussusception segment was performed. No pathological lead point was identified on imaging or intra-operatively. The patient made a full recovery post operatively. Conclusion Our case report illustrates a rare diagnosis of abdominal pain and vomiting, presenting to the Emergency Department. With increasing accessibility to CT, most cases of adult intussusception are found incidentally on contrast CT of the abdomen and pelvis. While there is no consensus on management, it is more common for adult intussusception patients to have operative intervention, compared to childhood intussusception.