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CC BY 4.0 · Surg J (N Y) 2021; 07(04): e271-e274
DOI: 10.1055/s-0041-1733834
Case Report

Triple Intussusception in an Adult—A Rare Presentation of Adenocarcinoma Ileum

Kirankumar P. Jadhav
1   Department of Surgery, B. J. Government Medical College and Sassoon General Hospital, Pune, Maharashtra, India
,
Gayathri Krishnan 
1   Department of Surgery, B. J. Government Medical College and Sassoon General Hospital, Pune, Maharashtra, India
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Abstract

Intestinal intussusception is uncommon in adults. It occurs more often in the small intestine than in the colon. In adults, when small bowel intussusception occurs, it can be due to a malignant lead point. Malignant etiology is most frequently due to diffuse metastatic disease. We present a rare case of an 18-year-old woman who was diagnosed with jejunojejunal, jejunoileal, and colocolic intussusceptions. She presented with vomiting, abdominal pain, and passage of semisolid stools for 5 days. During emergency exploratory laparotomy, multiple polyps were found in the jejunum, ileum, and sigmoid. Jejunotomy and sigmoidotomy were done to remove the respective polyps. The ileal polyp showed hemorrhagic changes; hence, an intraoperative decision was taken to proceed with resection and anastomosis. On histopathological examination, the resected ileal part showed moderately differentiated adenocarcinoma (grade 2) arising from an adenomatous polyp, while the jejunal polyp and sigmoid polyp were adenomatous polyps with low-grade dysplasia. Patient received six cycles of adjuvant chemotherapy consisting of capecitabine and oxaliplatin (CAPEOX regimen). After 2 years, she is symptom free with a normal colonoscopy. The treatment of intussusception in adults typically involves surgery, often with bowel resection as there is always a pathologic leading cause which may be malignant, like in our case.

Keywords

adult intussusceptions - adenocarcinoma ileum - multiple intussusceptions

Informed Consent

Informed consent was obtained from the participant.




Publication History

Received: 27 May 2021

Accepted: 16 June 2021

Article published online:
05 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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