Ileo ileal intussusception secondary to Meckel's diverticulum

Case contributed by Dr Mahmoud Yacout Alabd

Presentation

Acute onset abdominal pain with mild tenderness.

Patient Data

Age: 17 y
Gender: Female

Bowel within bowel with target sign and appearance consisting of a distended bowel segment with double lumen and intraluminal mesenteric fat and vessels that were pulled inwards by the intussuscepting segment. The affected segment appears to be small bowel, most likely an ileal loop. No underlying pathology, such as enlarged lymph node, polyp or mass, could be identified in this CT study as a leading point to the intussusception. The bowel is not obstructed. 

A Meckel's diverticulum was found intra-operatively as the leading point to the intussusception, the intussuscepting loop was reduced and the affected segment was excised with anastomosis.

Case Discussion

Primary intussusception is only seen in newborn children. Adult type intussusception is usually secondary to an underlying pathology such as intestinal lymphoma, carcinoma or polyps...etc. It is very unusual to see intussusception in such age (17 years) with no definite underlying pathology. A hidden pathology, such as a small polyp or lipoma or mild form of intestinal lymphoma, that is hard to be identified within the distorted normal bowel appearance in case of intussusception, must be suspected.

In this case a non inflamed Meckel's diverticulum, which in this case is also very hard to be identified, the leading point to the intussusception. 

PlayAdd to Share

Case information

rID: 42769
Case created: 7th Feb 2016
Last edited: 8th Feb 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.