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Complicated Idiopathic Ileo-ileal Intussusception in a 45-year-old Male: A Case Report

Background: Intestinal intussusception is a surgical emergency often responsible for bowel obstruction in children below three years of age. Intussusception occurring in adults is rare. In fact, it represents just 5% of all intussusceptions, of which only 1% present with complications such as bowel obstruction and peritonitis. We present the case of an idiopathic ileoileal intussusception in a 45-year-old male, presenting as peritonitis.

Case presentation: A 45-year-old male from the Adamawa region of Cameroon, with no peculiar past medical history, presented with a four days history of exacerbating abdominal pains, repeated vomiting and obstipation. Clinical and paraclinical findings were in favor of peritonitis. An exploratory laparotomy was done, and an ileoileal intussusception seen per-operative. The intussusceptum was necrotic and the intussuscipiens oedematous and perforated. Both (intussuscipiens and intussusceptum) were void of any structural lesions responsible for the intussusception. Resection and anastomosis was done, followed by post-operative antibiotherapy. The postoperative period was unremarkable and the patient was discharged on day 10. A follow up visit for 2 weeks after discharge revealed a healing abdominal wound and normal bowel functions.

Conclusion: Intussusception is rare in adults, and its complications even rarer. We described a rare case of idiopathic intussusception in an adult presenting as peritonitis. We therefore advise that physicians working in emergency departments consider intussusception in adults presenting with peritonitis.

Author(s): Nkembe Marius Nkembe, Clarence Mbanga and Valirie Ndip Agbor

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