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Resident PGY 2
Henry Ford Macomb
Introduction: When compared to children, intussusception is rare in adults. It comprises only 5% of all intussusceptions and represents only 1% of all bowel obstructions. The mean age in adults is 50 years of age with no gender predominance. It typically presents with nonspecific symptoms and clinical findings. Thus, it is important to maintain a broad differential in order to avoid delay in diagnosis and treatment.
Case presentation: We discuss the case of a 93-year-old male with surgical history of open appendectomy who presented to the emergency department with intermittent episodes of diffuse abdominal cramping. On physical exam, abdomen was slightly distended without tenderness or peritoneal signs. CT abdomen/pelvis demonstrated a partial small bowel obstruction caused by intussusception secondary to a submucosal lipoma. Exploratory laparotomy confirmed our diagnosis.
Conclusion: Malignancy accounts for up to 30% of cases of intussusception occurring in the small intestine in adults. Other causes include polyps, Meckel’s diverticulum, strictures, benign neoplasms, or iatrogenic. Its lack of pathognomonic presentation can complicate the diagnosis and lead to delay which may be catastrophic to the patient. Therefore, high suspicion, early detection, diagnosis, and definitive treatment remains essential.
Lozano, Ana; Pansuriya, Shyamal; and Prakash, Shivanhalli, "An Unexpected Cause of Small Bowel Obstruction in an Elderly Gentleman" (2020). Case Reports. 55.