Jejunal intussusception: a rare cause of an acute abdomen in adults

Abstract

Abdominal pain secondary to intussusception is a common presentation in the paediatric population but rare in adults. Diagnosis is often difficult due to non-specific signs and symptoms. Adult intussusception presents more insidiously with intermittent abdominal pain and signs and symptoms of an acute abdomen are rare. In children, the aetiological factor is usually idiopathic, whereas intussusception in adults is more commonly due to an underlying pathology giving rise to a lead point. Consequently the treatment of choice is different-while it is supportive in children, surgical management is typically indicated in adults. In addition, the causes of a lead point precipitating adult intussusception are different depending on whether they arise from the small or large bowel. This report presents a case of jejunal intussusception in a 30-year-old man with a characteristic CT scan who required exploratory laparotomy and small bowel resection.

Figure 1

Abdominal radiograph illustrating a dilated small bowel loop in the right upper quadrant (arrow) with scanty bowel gas elsewhere.

Figure 2

Axial-enhanced CT of the abdomen and pelvis illustrating a proximal jejunal intussusception—a target-shaped lesion with a lead point (arrow). The fat density seen in the centre of the lesion represents mesenteric fat.

Figure 3

Coronal reconstruction of the CT of the abdomen and pelvis illustrating the proximal jejunal intussusception in a longitudinal section as a sausage-shaped lesion with a lead point (arrow).