Adult ileocolic intussusception - rare cause of epigastric pain
By David Johnson, Royal Melbourne Hospital
Adult intussusception is a rare acute medical condition which often presents with non-specific clinical
symptoms and poses a challenging imaging diagnosis.
This case report describes an incidental finding of a large ileocolic intussusception of a 21-year-old female
presenting with recurrent epigastric pain in a setting of longstanding gastritis.
Initially referred for targeted biliary ultrasound, an extended examination was performed on the basis of
the patient’s clinical pain. This identified biliary sludge, distended bowel loops and a 10cm abdominal mass
in the midline pelvis. The mass displayed a “target”-like appearance in the axial plane and “pseudo-kidney”
characteristics in the long axis.
Subsequent computed tomography confirmed a radiological diagnosis of ileocolic intussusception with likely
small bowel ischaemia and associated small bowel obstruction.
Emergency exploratory laparotomy and hemicolectomy identified over 55cm of non-reducible, compromised
bowel. Pathological examination diagnosed a 3cm non-cancerous polypoid tumour as the lead-point of
intussusception.
Despite hospital-acquired infection with subsequent collection drainage, the patient recovered well within two
weeks of diagnosis.