What is it about?
Intussusception is a medical term used to describe a segment of bowel invaginating into another segment. This predominantly affects children yet our report is about a case of intussusception in an elderly female. It is also interesting because this patient's bowel perforated at a site separate and distal to the intussusception which has never been documented before. This is thought to be due to a closed loop obstruction caused by faecal impaction. It also highlights that the disease can present very vaguely and that diagnosis relies on CT imaging.
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Why is it important?
Intussusception rarely presents in adults. When it does occur in this population the symptoms are non-specific, unlike in paediatric patients. CT imaging is the gold standard of radiological imaging for the diagnosis of intussusception and surgery is the definitive form of management in large intestine intussusception due to the underlying cause being malignancy . This is the first documented case of the perforation site being separate to the site of intussusception. This may have been due to a closed loop obstruction limited distally by faeces
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This page is a summary of: Diagnostic challenge of the non-specific presentation of adult intussusception, BMJ Case Reports, November 2019, BMJ, DOI: 10.1136/bcr-2019-229931.
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