AB151. SOH24AB_229. Inflammatory fibroid polyp of the small intestine presenting as small bowel obstruction with intussusception: a case report and systematic review of the literature
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AB151. SOH24AB_229. Inflammatory fibroid polyp of the small intestine presenting as small bowel obstruction with intussusception: a case report and systematic review of the literature

Cian Hehir1, Gavin Calpin1, Gavin Dowling1,2, Arnold Hill1,2,3

1Department of Surgery, Beaumont Hospital, Dublin, Ireland; 2Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland; 3School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland

Background: Intussusception is a rare in adults, accounting for only 1% of bowel obstructions. Of this small cohort however, a pathological lesion is found to act as a lead point in >90% of cases. Inflammatory fibroid polyp (IFP) has been previously termed ‘the great mimicker’ due to its close resemblance to invasive masses such as spindle cell tumours. Immunohistochemistry provides a useful means of definite subtyping with most IFP lesions staining positive for CD34 and, to a lesser extend vimentin and CD117.

Case Description: A retrospective chart review was carried out following the presentation of a 74-year-old female to our department with acute intestinal obstruction. Computerized tomography (CT) scan of the abdomen and pelvis revealed a small bowel obstruction with intussusception secondary to an intramural mass lesion. The patient was treated with emergency laparotomy with segmental bowel resection and side to side anastomosis. A systematic review of the available literature was carried out using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Histopathological and immunohistochemical analysis demonstrated that the lesional cells stained positive for vimentin, SMA and CD34. Desmin, S100, cytokeratin DOG-1, C-KIT and ALK-1 were negative. These findings were consistent with IFP in terms of morphology and immunohistochemical profile. Twenty-four cases of IFP occurrence within the small bowel have been reported to date. Immunohistochemical profile was available in only 29% of cases (n=7).

Conclusions: IFP can present in a diagnostically challenging manner. There is a lack of reporting of such benign tumours and their varied presentations within the small bowel from a surgical, histopathological and immunohistochemical perspective. This case report aims to add to the small body of research reporting on this topic.

Keywords: Adult intussusception; bowel obstruction; immunohistochemistry; inflammatory fibroid polyp (IFP); spindle-cell

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab151
Cite this abstract as: Hehir C, Calpin G, Dowling G, Hill A. AB151. SOH24AB_229. Inflammatory fibroid polyp of the small intestine presenting as small bowel obstruction with intussusception: a case report and systematic review of the literature. Mesentery Peritoneum 2024;8:AB151.

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