Adult Jejuno-jejunal intussusception due to inflammatory fibroid polyp

Abstract

Rationale: Intussusception is defined as the invagination or telescoping of a proximal portion of the intestine into the distal portion of the intestine. Intussusception can occur at any age but is more common among children. Most cases of intussusception in adults have a pathological lead point. Inflammatory fibroid polyp (IFP) is a rare benign tumor-like lesion arising from the submucosa of the gastrointestinal tract that can cause intussusception in adults. Here, we report a case of adult intussusception due to IFP. We also present a literature review of 31 reports including 34 cases between 2012 and December 2019, which shows a mean age of 45.4 ± 14.2 years and female dominance (23/34) of intussusception due to IFP. Patient concerns: A 47-year-old man presented with a half-day history of epigastric abdominal pain. Physical examination revealed distension and tenderness of the upper abdomen. Computed tomography (CT) of the abdomen and pelvis demonstrated intussusception of the jejunum along with a suspicious jejunal mass associated with mesenteric lymphadenopathies. Diagnosis: Intussusception of the jejunum along with a suspicious jejunal mass, and histopathological examination of the resected specimen showed IFP. Interventions: The patient underwent emergency laparotomy. The intussusception was resected without attempts for reduction. Outcomes: The postoperative period was uneventful, and the patient was discharged on the fourth postoperative day. Lessons: Intussusception in adults is rare, especially that secondary to IFP. The most commonly used diagnostic tool for adult intussusception is abdominal CT, and the optimal management is resection of the involved bowel segment without reduction if malignancy cannot be ruled out.

Combined Ileoileal and Ileocolic Intussusception Secondary to Inflammatory Fibroid Polyp in an Adult: A Case Report

“…Resection by laparoscopy or laparotomy is the recommended option for intussusception secondary to IFP to prevent the development of bowel ischemia, necrosis, and perforation. IFP secondary to intestinal intussusception, in the past decade, has been reviewed and published by Kao et al in 2020 [10]. However, this is the first special case report concerning combined ileoileal and ileocolic intussusception caused by IFP, which is initially diagnosed as two target structures found by abdominal CT.…”

Adult intussusception due to ileal polyp - A case report

“…However, improper reduction may increase the risk of perforation of bowels, complications of anastomosis, propagation of malignancy. Therefore, to avoid all these potential complications, bowel resection has been accomplished in most of the cases [3] .…”

Jejunojejunal intussusception of a sutured enterotomy site after takedown and primary repair of persistent enterocutaneous fistula: a case report

“…Intussusception, or telescoping of the bowel, most often occurs in infants and children with typical presentation of abdominal pain, bloody stool and abdominal mass [ 9 ]. Adult intussusception, a rare finding accounts for only 5% of all intussusception cases, with > 90% of intussusception in adults due to secondary causes [ 10 ]. Tumors are the most common cause of intussusception in adults, and accounts for 63–77% of cases [ 11 ].…”