Adult gastro-gastric intussusception; a case report

Abstract

Introduction and importance: Intussusception in the proximal bowel is extremely rare, with only a few reported cases of gastroduodenal intussusception (GDI). Gastrogastric intussusception is the rarest form of intussusception in adults. Here, we present an exceptionally rare case of gastro-gastric intussusception caused by a gastric Gastrointestinal Stromal Tumor (GIST).

Case presentation: A 36-year-old male presented with acute abdominal pain, suggestive of intussusception. The preoperative evaluation was unable to pinpoint the exact location or cause of the intussusception.

Clinical discussion: Intraoperative diagnosis of gastro-gastric intussusception was made, and the patient was treated with a gentle reduction of the intussusception, followed by a distal gastrectomy with Billroth I anastomosis. He was relieved of his symptoms and has been recurrence-free for the past two years.

Conclusions: Gastro-gastric intussusception is an exceedingly rare type of foregut intussusception, which presents with non-specific clinical presentation and commonly occurs in the presence of an underlying pathology. A delay in diagnosis and treatment may be fatal, so a high index of suspicion and early surgical management is paramount.

Keywords: Adult intussusception; Ethiopia; GIST; Gastro-gastric intussusception.

Fig. 1

Intraoperative pictures: (A, B) Intra-operative picture showing gastro-gastric intussusception (C) Intra-operative picture after manual reduction of the intussusceptum (D) large ulcerated mass after distal gastrectomy (E) Intraoperative picture distal gastrectomy with Billroth I anastomosis.