Enteric duplication cyst as a leading point for ileoileal intussusception in an adult: A rare cause of complete small intestinal obstruction

Abstract

Duplication of alimentary tract (DAT) presenting as an ileoileal intussusception is a very rare clinical entity. Herein, a case of an ileoileal intussusception due to DAT is presented. A 32-year-old woman was hospitalized due to diffuse, intermittent abdominal pain, vomiting and constipation for 3 d associated with abdominal distention. Plain abdominal X-ray revealed dilated small bowel. Abdominal computed tomography showed grossly dilated small bowel with “sausage” and “doughnut” signs of small bowel intussusception. She underwent laparotomy, with findings of ileoileal intussusception due to a cystic lesion adjacent to the mesenteric side. Resection of the cystic lesion along with the affected segment of intestine, with an end to end anastomosis was performed. The histopathology was consistent with enteric duplication cyst. This case highlights the DAT, although, an uncommon cause of adult ileoileal intussusception should be considered in the differential diagnosis of intussusception in adults, particularly when the leading point is a cystic lesion.

Keywords: Enteric cyst, Ileoileal intussusception, Duplication of alimentary tract, Small intestinal obstruction, Doughnut sign

Core tip: I have reported this case of ileoileal intussusception in an adult due to duplication of alimentary tract (DAT) being the cause of intussusception. Although intussusception is a well-known surgical condition, the presence of DAT as a leading point is extremely rare. Only few cases have been reported in the English literature. Computed tomography, although identified the intussusception, the exploratory laparotomy established the DAT as a leading point for the ileoileal intussusception. Resection of the enteric cyst along with the affected intestine, and end to end anastomosis was performed. The histopathology was consistent with enteric duplication cyst.