Chapa LAF, Salgado CLE, Garza CAA, Villafranca ARI, Alanís RÓC

Language: Spanish
References: 17
Page: 113-117
PDF size: 299.39 Kb.

ABSTRACT

Introduction: An intussusception occurs when two adjacent intestinal segments invaginate. It is uncommon in adults (1% of intestinal obstructions), caused by a structural pathology such as polyps, submucosal lipomas or Meckel’s diverticula, with malignant neoplasms being a considerable differential diagnosis. We present a case of ileocecal intussusception secondary to Vanek’s tumor or fibroid inflammatory polyp. Case presentation: Male, 41 years old, with abdominal pain of one month of evolution, intermittent, diffuse, sometimes aggravated after food intake and attenuated with analgesic-antispasmodic drugs and nausea. Two hours before admission, he presented sudden abdominal pain in the right iliac fossa. He went to the emergency department where an abdominal tomography was performed and a heterogeneous mass in an ileocolic junction compatible with intestinal intussusception was identified. During surgery, the intussuscepted portion wasn’t reduced, no lymph nodes, liver lesions or peritoneal implants were observed. Right hemicolectomy was performed with ileotransverse anastomosis under laparoscopy, without eventualities. Conclusions: The diagnosis requires high suspicion. The tomography with or without barium enema proves to be the most effective imaging method. In adults, intussusception always requires a surgical approach, resection being the procedure of choice. Since small bowel injuries are usually benign, segmental resections are appropriate, while colonic lesions are usually malignant, so oncological resections are recommended. As for Vanek’s tumor, a benign pathology, its treatment consists of resection without any other intervention, provided that it has been completely resected.

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