Introduction: Adult intussusception is rare and typically associated with an underlying lead point. Inflammatory pseudotumor, a rare benign lesion of uncertain etiology, can serve as such a lead point in the small bowel. The occurrence of double intussusception in this context is exceptionally uncommon.
Presentation of case: A 55-year-old woman presented with signs of small bowel obstruction. Imaging(Fig. 1-11) revealed ileo-ileal intussusception. Intraoperatively(Fig. 16-18), a Double intussusception configuration was observed where one intussuscepted segment acted as the lead point for a second. A firm lesion at the apex was resected. Histopathology confirmed Inflammatory Pseudotumor(Fig. 12-15). The patient recovered uneventfully and remained asymptomatic at 6-month follow-up.
Discussion: Double intussusception is extremely rare in adults. In this case, an inflammatory pseudotumor triggered an initial ileo-ileal intussusception, which subsequently served as the lead point for a second. The unusual etiology and configuration can pose diagnostic challenges, as radiological imaging may not fully reveal the complexity. Surgical intervention was required for definitive management.
Conclusion: Double ileo-ileal intussusception caused by an inflammatory pseudotumor represents an exceedingly rare etiology of acute intestinal obstruction in adults. Prompt surgical treatment is critical. This case highlights the importance of considering rare benign tumors as potential lead points in adult intussusception.
Keywords: Adult intussusception; Case report; Ileum; Inflammatory pseudotumor; Intussusception; Small bowel obstruction.
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