A RARE CASE SERIES OF ADULT INTUSSUSCEPTION IN RURAL AREA : CHALLENGE IN DIAGNOSING AND MANAGEMENT UPDATE

Stacia Novia Marta; Hendrik B Mengga

Volume : IX, Issue : VIII, August - 2019

A RARE CASE SERIES OF ADULT INTUSSUSCEPTION IN RURAL AREA : CHALLENGE IN DIAGNOSING AND MANAGEMENT UPDATE

Stacia Novia Marta, Hendrik B Mengga

Abstract :

Background: Adult intussusception is a rare pathology representing 5–16% of all cases and are responsible for 1–5% of all bowel obstruction. The classic symptoms as found in children are often not present thus delaying diagnosis. The aim of this paper is to raise an awareness to the potential diagnosis and present a recent update in the management of adult intussusception Case: We report 2 cases of adult intussusception with different clinical symptoms and leading point. Case 1, 53 years old man with a main clinical feature of progressing intermittent abdominal pain and no sign of obstruction and case 2, 35 years old woman presenting bowel obstruction. In both patients, laparotomy confirmed the diagnosis of ileoileal and ileocolic intussusception. Pathological finding was chronic colitis with A. Lumicoides infestation and intact polypoid lesion of cavernous haemangioma in caecum. Both patient underwent resection without prior reduction and anastomosis. Early feeding was given 24h post surgery with good tolerance and was sent home after 5 days of hospitalization. Conclusion: Adult intussusception is a rare condition with non–specific clinical symptoms which may further delay the diagnosis thus giving rise to greater challenge especially in rural areas with low resources. Surgery is the definitive treatment for adult intussusception. Several recent literature show that reduction of intussuscepted bowel is considered safe in benign lesion and if there was no sign of bowel ischemia in order to avoid short bowel syndrome. Early feeding post operatively is considered safe according to ERAS.