AB172. SOH22ABS201. Telescoping small bowel in an elderly gentleman

Background: Intussusception, defined as telescoping of a part of the bowel into itself, is the most common abdominal emergency in paediatrics less than 2 years of age. The triad of abdominal pain, palpable sausage-shaped mass and red currant-jelly stool that is seen in 15% of the paediatric population is very rare in the adult population. Adults usually present with intermittent crampy abdominal pain and can sometimes be associated with intermittent bowel obstruction symptoms such as nausea, vomiting, gastrointestinal bleeding and constipation. This case report describes an elderly gentleman presenting with anaemia secondary to an intussusception with no symptoms of obstruction.

Methods: The patient underwent further investigations including oesophago-gastro-duodenoscopy (OGD) and colonoscopy which was unremarkable. Computerized tomography abdomen pelvis (CTAP) showed abnormal thickening of a loop of terminal ileum likely representing an intussusception but underlying malignancy could not be outruled. An exploratory laparoscopy was performed.

Results: An intussusception of the distal terminal ileum was seen containing a 1.5 cm smooth, firm, round mass as a lead point. The segment involved was resected and primary anastomosis performed. Histology showed a submucosal lipoma.

Conclusions: Although intussusception is rare in the adult population, it should be taken into consideration for any patients presenting with anaemia.

Keywords: Anaemia; intussusception; lipoma; small bowel; telescoping