IDIOPATHIC SMALL BOWEL INTUSSUSCEPTION IN A YOUNG ADULT: A CASE REPORT ON CONSERVATIVE SURGICAL MANAGEMENT

Abstract

Introduction: Intestinal intussusception is a condition in which a portion of the intestinal loop invaginates into another adjacent segment (1). Ileocolic intussusception is the most common, leading to complications such as intestinal obstruction, ischemia, or small bowel inflammation (2,3). It is more common in children or those over 50 years of age; when it occurs in young adults, it is a serious condition (5,6). The etiology of intussusception in children is not well defined (11). Intussusceptions are classified as benign or malignant. Regarding malignant causes, metastatic diseases are more relevant (1). Symptoms depend on age group; in children, they may be evidenced by the classic triad: abdominal mass, abdominal pain, and redcurrant jelly-like stools (8). In adults, the most common symptoms are abdominal pain and a palpable mass (9). The gold standard for diagnosis is abdominal computed tomography (CT), either after barium enema or abdominal ultrasound, the latter being less specific (7,10). Case Presentation: A 36-year-old woman was admitted to the Costa Rica Hospital Foundation after experiencing moderate-to-severe abdominal pain. Laboratory tests were unremarkable, and a full abdominal CT scan revealed small bowel intussusception. The patient was kept fasting, antibiotic therapy was initiated, and she underwent exploratory laparotomy. A loop reversal maneuver was performed, resulting in uneventful repair of the intussusception. Conclusion: Clinical and imaging findings can provide greater confidence in surgical decision-making in cases of intussusception in adults. Successful treatment of intestinal intussusception depends on early diagnosis, aiming to avoid potential complications, such as ischemia and necrosis of the bowel, resulting in a better prognosis. Therefore, quality surgical treatment is recommended for adults with this condition to reverse the condition.