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Clinical Images  |   April 2016
Ileocecal Intussusception
Author Notes
  • From Imaging Service at the VA New Jersey Health Care System in East Orange. 
  •  *Address correspondence to Michael A. Cook, DO, VA New Jersey Health Care System, 385 Tremont Ave, East Orange, NJ 07018-1023. E-mail: michael.cook2@va.gov
     
Article Information
Gastroenterology / Imaging / Clinical Images
Clinical Images   |   April 2016
Ileocecal Intussusception
The Journal of the American Osteopathic Association, April 2016, Vol. 116, 268. doi:10.7556/jaoa.2016.053
The Journal of the American Osteopathic Association, April 2016, Vol. 116, 268. doi:10.7556/jaoa.2016.053
A 68-year-old man with a history of Clostridium difficile colitis presented to the emergency department with recurrent abdominal pain and sudden-onset abdominal distension and vomiting. Physical examination revealed that the abdomen was soft, distended, and tender with hypoactive bowel sounds. A computed tomographic scan of the abdomen and pelvis (image A and image B) revealed an obstruction due to intussusception of the ileum into the cecum. The small bowel was diffusely distended. During a surgical procedure to remove the obstruction, an ileocecal intussusception was confirmed and a right hemicolectomy was performed. Histologic findings revealed acute ulcerative and pseudomembranous colitis with massive submucosal edema. The patient had an unremarkable recovery. 
Intussusception is a rare cause of bowel obstruction in adults. Most cases are associated with a pathologic lead point, such as a mass, which is often malignant.1,2 The radiologic diagnosis is established by identifying bowel within bowel that demonstrates mesenteric fat and vessels within the intussuscipiens.3 Management of ileocecal intussusception requires surgical intervention. 
References
Croome KP, Colquhoun PH. Intussusception in adults. Can J Surg. 2007;50(6):E13-E14. [PubMed]
Choi SH, Han JK, Kim SH, et al Intussusception in adults: from stomach to rectum. AJR Am J Roentgenol. 2004;183(3):691-698. [CrossRef] [PubMed]
Gollub MJ. Colonic intussusception: clinical and radiographic features. AJR Am J Roentgenol. 2011;196(5):W580-W585. doi:10.2214/AJR.10.5112. [CrossRef] [PubMed]