A Case of Idiopathic Small Bowel Intussusception in an Adult

Abstract

We report a case of idiopathic small bowel intussusception in an adult. The patient was a man in his 80s with a medical history of hypertension and pulmonary fibrosis for which he was receiving medical treatment and home oxygen therapy. In April of year X, he presented to our emergency department with abdominal pain and nausea. Abdominal contrast-enhanced computed tomography revealed the target sign, and we made the diagnosis of small bowel intussusception. Emergency surgery was performed approximately 8 hours after symptom onset. Intraoperatively, a segment of small bowel intussusception measuring 40 cm in length was identified 130 cm distal to the ligament of Treitz. After manual reduction of the intussusception, visual and tactile inspection of the bowel revealed no abnormalities other than edema. However, even though there were no obvious signs of intestinal ischemia, we still performed partial small bowel resection considering the possibility of organic lesions at the leading edge of the involved bowel segment. Gross and histopathological examination of the resected specimen revealed no organic lesions and the patient was diagnosed as having suffered from idiopathic small bowel intussusception. Partial small bowel resection is an acceptable option in adult cases of small bowel intussusception, considering their rarity and the difficulty of excluding underlying lesions preoperatively and intraoperatively.