Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction

IntroductionIntussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should undergo surgery. Here we describe a case of ileal inf...

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Main Authors: Claudio Guerci, Francesco Colombo, Gloria Goi, Pietro Zerbi, Barbara Pirrò, Piergiorgio Danelli
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-04-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2022.876396/full
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author Claudio Guerci
Francesco Colombo
Gloria Goi
Pietro Zerbi
Barbara Pirrò
Piergiorgio Danelli
author_facet Claudio Guerci
Francesco Colombo
Gloria Goi
Pietro Zerbi
Barbara Pirrò
Piergiorgio Danelli
author_sort Claudio Guerci
collection DOAJ
description IntroductionIntussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should undergo surgery. Here we describe a case of ileal inflammatory fibroid polyp (IFP), presenting with ileo-ileal intussusception and obstruction.Case reportA 54-year-old Caucasian woman presented for acute abdominal pain. A radiography and a CT of the abdomen were performed, which showed signs of occlusion due to an ileo-ileal intussusception. An urgent laparoscopy was performed, the intussusception was extracorporeally reduced, the ileal segment involved was resected, and an ileo-ileal anastomosis was performed. The intussusception seemed to be caused by a 3-cm intra-mural lesion.DiscussionIntussusception is a surgical concern. While most cases are idiopathic in children, 90% of adult intussusceptions are caused by underlying diseases. Therefore, intussusception in adults should undergo surgery. Radiology is necessary for the diagnosis: the CT scan helps localizing the lesion and shows pathognomonic signs. This case report analyzes an intussusception caused by an inflammatory fibroid polyp. Accurate diagnosis of IFP is only possible with histopathological examination, helped by immunohistochemistry. The differential diagnosis is important because some lesions are malignant.ConclusionWe reported a case of intussusception caused by an IFP. The diagnosis was made with a CT scan together with intraoperative findings and histopathological examination, which excluded potential differential diagnoses. The patient underwent an explorative laparoscopy, with an ileal resection and anastomosis. Due to the risk of malignancy, surgery is mandatory.
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spelling doaj.art-9941fdcef2fe4758b2308c50c1a1e97f2022-12-22T02:22:25ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-04-01910.3389/fsurg.2022.876396876396Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal ObstructionClaudio Guerci0Francesco Colombo1Gloria Goi2Pietro Zerbi3Barbara Pirrò4Piergiorgio Danelli5Department of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, ItalyDepartment of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, ItalyDepartment of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, ItalyPathology Unit, Department of Biomedical and Clinical Sciences “L. Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, ItalyDepartment of Radiology, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, ItalyDepartment of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, ItalyIntroductionIntussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should undergo surgery. Here we describe a case of ileal inflammatory fibroid polyp (IFP), presenting with ileo-ileal intussusception and obstruction.Case reportA 54-year-old Caucasian woman presented for acute abdominal pain. A radiography and a CT of the abdomen were performed, which showed signs of occlusion due to an ileo-ileal intussusception. An urgent laparoscopy was performed, the intussusception was extracorporeally reduced, the ileal segment involved was resected, and an ileo-ileal anastomosis was performed. The intussusception seemed to be caused by a 3-cm intra-mural lesion.DiscussionIntussusception is a surgical concern. While most cases are idiopathic in children, 90% of adult intussusceptions are caused by underlying diseases. Therefore, intussusception in adults should undergo surgery. Radiology is necessary for the diagnosis: the CT scan helps localizing the lesion and shows pathognomonic signs. This case report analyzes an intussusception caused by an inflammatory fibroid polyp. Accurate diagnosis of IFP is only possible with histopathological examination, helped by immunohistochemistry. The differential diagnosis is important because some lesions are malignant.ConclusionWe reported a case of intussusception caused by an IFP. The diagnosis was made with a CT scan together with intraoperative findings and histopathological examination, which excluded potential differential diagnoses. The patient underwent an explorative laparoscopy, with an ileal resection and anastomosis. Due to the risk of malignancy, surgery is mandatory.https://www.frontiersin.org/articles/10.3389/fsurg.2022.876396/fullintussusceptionfibroid polypsurgeryhistologyIFPlaparoscopy
spellingShingle Claudio Guerci
Francesco Colombo
Gloria Goi
Pietro Zerbi
Barbara Pirrò
Piergiorgio Danelli
Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
Frontiers in Surgery
intussusception
fibroid polyp
surgery
histology
IFP
laparoscopy
title Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
title_full Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
title_fullStr Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
title_full_unstemmed Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
title_short Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
title_sort case report ileo ileal intussusception secondary to inflammatory fibroid polyp a rare cause of intestinal obstruction
topic intussusception
fibroid polyp
surgery
histology
IFP
laparoscopy
url https://www.frontiersin.org/articles/10.3389/fsurg.2022.876396/full
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