
I saw a lady in the ER presenting with abdominal pain, nausea, progressive anorexia for about 6 weeks. A CT scan suggestive high grade obstruction with intussusception of the small bowel. Now we don't see something like this everyday. Intussusception occurs when the proximal bowel sort of telescopes itself into the more distal bowel lumen, leading to congestion, obstruction, and, in some cases, ischemia of the involved segments.
Intussusception in an adult always raises concerns for underlying malignancy. Intra-lumenal masses or tumors can act as a lead point wherein, via peristalsis, the more proximal bowel can "grab hold" and intussuscept.
Fortunately, this patient had a benign submucosal fibroid tumor that led to her intussusception. We resented the segment of bowel harboring the mass and she went home a happy camper in a couple of days. Many times, intussusception is the initial presentation of a more sinister process, like lymphoma, or carcinoid tumors, or invasive adenocarcinomas.
Intussusception in an adult always raises concerns for underlying malignancy. Intra-lumenal masses or tumors can act as a lead point wherein, via peristalsis, the more proximal bowel can "grab hold" and intussuscept.
Fortunately, this patient had a benign submucosal fibroid tumor that led to her intussusception. We resented the segment of bowel harboring the mass and she went home a happy camper in a couple of days. Many times, intussusception is the initial presentation of a more sinister process, like lymphoma, or carcinoid tumors, or invasive adenocarcinomas.