Idiopathic intestinal intussusception causing intestinal obstruction in an adult: a case report and review of the literature

Abstract

BACKGROUND: Adult intussusception is an uncommon clinical condition, representing a rare cause of intestinal obstruction. Unlike the pediatric form, most adult cases are secondary to an identifiable pathological lead point. Idiopathic intussusception, particularly involving the small bowel, is exceedingly rare and poses diagnostic and therapeutic challenges. CASE PRESENTATION: We report the case of a 42-year-old woman with no prior abdominal surgery who presented with a three-day history of abdominal pain, vomiting, and cessation of stool and flatus. Physical examination revealed mild abdominal distension without peritoneal signs. Abdominal computed tomography demonstrated a jejuno-jejunal intussusception with the classic "target" configuration and no detectable underlying lesion. The patient underwent an exploratory laparotomy, which confirmed a jejuno-jejunal intussusception without any pathological lead point. Gentle manual reduction was performed, and no resection was required. The postoperative course was uneventful, and the patient was discharged on postoperative day three. DISCUSSION: Adult idiopathic intussusception is rare, accounting for a small minority of adult intussusception cases. CT imaging is the cornerstone of diagnosis, enabling visualization of characteristic features and assessment of complications. Surgical exploration remains the standard of care, with management tailored to intraoperative findings. Reduction without resection is justified when the bowel is viable, and no underlying pathology is evident. CONCLUSION: Idiopathic small bowel intussusception in adults is a diagnostic rarity that should be considered in cases of unexplained bowel obstruction. Early diagnosis and tailored surgical management can ensure favorable outcomes while avoiding unnecessary bowel resection.