Ileoileal intussusception in the adult patient secondary to a fibroma: An organ-preserving approach to management

Abstract

We present a rare case of adult intussusception (AI) due to a small bowel fibroma, which presented as recurrent subacute symptoms. To our knowledge, this is the first reported case managed by intraluminal excision of the causative lesion by enterotomy as opposed to bowel resection. A 34-year-old woman presented with recurrent colicky abdominal pain. Computed tomography demonstrated ileoileal intussusception, with magnetic resonance imaging revealing a 2.3-cm intraluminal lesion acting as a lead point. The patient underwent laparotomy and the intussusception was reduced. Palpation of the lesion demonstrated a pedunculated polyp without suspicious features; so the lesion was resected via enterotomy as opposed to small bowel resection. Histopathological analysis diagnosed a benign fibroma. AI is a rare but important entity, with potentially devastating consequences for delayed diagnosis. The majority of lesions causing AI are benign and may be amenable to intraluminal resection via enterotomy, thus avoiding unnecessary bowel resection.