Adult ileal intussusception with secondary obstruction

Case contributed by Jack Ren

Presentation

Vomiting, distended abdomen, previous abdominal surgery, diagnosis probable bowel obstruction.

Patient Data

Age: 88 years
Gender: Male

Normal bowel gas pattern. No free gas.

Mechanical small bowel obstruction secondary to proximal/ mid ileal intussusception at the left iliac fossa, with the dilated proximal small bowel measuring up to 4 cm in diameter.

No associated mass identified.

Contrast is seen in the distal ileum, suggesting this is not a complete obstruction.

No pneumoperitoneum to suggest perforation. No intraperitoneal free fluid.

Grossly enlarged prostate measuring approximately 72mmx 80mm x 75mm (TR x AP x SI).

Sigmoid diverticular disease without active diverticulitis. Multiple hepatic and bilateral renal cysts. Mildly atrophic bilateral kidneys. Minor fatty infiltration of the liver. Absent gallbladder. Prominent common bile duct. Fat herniation into bilateral inguinal canals.

Nasogastric tube in satisfactory position.

Image lung bases are clear. Cardiomegaly.

Multilevel lumbar vertebral degenerative changes.

Conclusion:

Mechanical small bowel obstruction secondary to proximal/ mid ileal intussusception.

This case also demonstrates the relative insensitivity of conventional radiographs for small bowel obstruction.

Case Discussion

Mechanical small bowel obstruction secondary to proximal/ mid ileal intussusception. 

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Case Information

rID: 30395
Case created: 7th Aug 2014
Last edited: 12th Feb 2017
Inclusion in quiz mode: Included

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