Jejunojejunal Adult Intussusception Presented with Rectal Bleeding

Iakovos Avramidis, Georgios Nalmpantidis, Nikolaos Giatas, Nikolaos Daleras, Ioanna Tsantila, Christina Nikolaidou, Stavros Giantikidis, Diamantis Zisis


Jejunojejunal adult intussusception is a rare disease. Secondary small intestine intussusception is even rarer and may result from intraluminal or extraluminal lesions. Adenocarcinoma may be found in up to 30% of small-intestine intussusception cases. We present a case of a 65 year old woman, who presented in the accident and emergency department of a rural hospital with lower gastrointestinal bleeding and abdominal pain. The patient underwent emergent gastroenterology and surgical consultation, imaging studies, urgent surgical therapy. Diagnosis of small-bowel adenocarcinoma was made on the basis of histologic examination. The patient had no risk factors for small-bowel adenocarcinoma. She did not receive chemotherapy after surgical therapy. She has been on a regular follow-up, without evidence of locoregional relapse or metastases. The probability for a given adult in Greece to present with rectal bleeding because of small bowel intussusception is estimated to be 1 to 2 cases annually in a 10 000 000 population. The probability  that the cause of intussusception is primary adenocarcinoma is even smaller. The disease has no specific symptoms or signs. High degree of clinical suspicion is needed in order a diagnosis will not be missed.

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