Non-operative Treatment for Intestinal Intussusception in Adults: A Case Report

Abstract

Intestinal intussusception, defined as the invagination of one segment of the intestine into an adjacent segment, although common in the pediatric population, is rare in adults and is often associated with neoplasms. The diagnosis is challenging, and contrast-enhanced computed tomography (CT) of the abdomen is the most sensitive method. Surgical treatment is the gold standard, with preoperative preparation focused on pain control and hydration.

In the reported case, a 68-year-old male patient presented with abdominal pain, distension, and the discharge of foul-smelling secretions from a jejunostomy, seeking care after five days of symptoms. The physical examination also indicated dehydration and significant weight loss, while laboratory tests revealed anemia and mild electrolyte imbalance. With a history of stenosing neoplasm of the esophagus and cardia, the patient was undergoing chemotherapy and had undergone jejunostomy due to progressive dysphagia about one month prior. The initial contrast-enhanced CT of the abdomen showed intussusception in a loop of the small intestine, distal to the jejunostomy, which was decompressed through a non-invasive procedure: the infusion of saline solution with diluted iodinated contrast through the Foley catheter of the jejunostomy, applied under pressure. After the procedure, on the same day, a follow-up CT of the abdomen demonstrated resolution of the intussusception.