article · International Journal of Research in Medical Sciences
Adult intussusception represents an uncommon cause of bowel obstruction that usually involves a distinct pathological lead point. Although submucosal lipomas in the small bowel are rare benign lesions, they can trigger intussusception if they become sufficiently large. A ninety-two-year-old man presented with acute abdominal pain and subocclusive symptoms. Given a background of bilateral inguinal hernias, clinicians initially suspected a strangulated hernia. However, contrast-enhanced computed tomography scanning revealed an uncomplicated jejunojejunal intussusception caused by a forty-six millimetre submucosal jejunal lipoma. The imaging confirmed the absence of bowel ischaemia. Non-surgical, conservative management led to a favourable clinical outcome for the patient. The case demonstrates that computed tomography plays a critical role in confirming the condition, identifying benign causes, ruling out ischaemic tissue damage, and steering clinical management decisions for elderly patients suffering from acute abdominal pain.
Bowel obstruction in elderly patients can mimic several common conditions, such as strangulated hernias, leading to potential misdiagnosis. This case shows how accurate imaging via computed tomography can prevent unnecessary invasive interventions by identifying benign causes and confirming the absence of tissue death, allowing safe, conservative treatment strategies in frail or elderly individuals.
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Adult intussusception is an uncommon cause of bowel obstruction and is usually associated with an identifiable pathological lead point. Among benign etiologies, submucosal lipomas of the small bowel are rare but may induce intussusception when they reach a significant size. We report the case of a 92-year-old man who presented with acute abdominal pain and subocclusive syndrome. Because of his history of bilateral inguinal hernias, strangulated hernia was initially suspected. Contrast-enhanced CT instead demonstrated an uncomplicated jejunojejunal intussusception caused by a 46-mm submucosal jejunal lipoma, with no evidence of bowel ischemia. Conservative management resulted in a favorable clinical outcome. This case highlights the pivotal role of CT in establishing the diagnosis, identifying the benign lead point, excluding ischemic complications, and guiding appropriate management in elderly patients presenting with acute abdominal pain.
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DOI: 10.18203/2320-6012.ijrms20263121
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