Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2020; 8(15): 3314-3319
Published online Aug 6, 2020. doi: 10.12998/wjcc.v8.i15.3314
Adult duodenal intussusception with horizontal adenoma: A rare case report
Kun-Peng Wang, Hao Jiang, Can Kong, Lie-Zhi Wang, Guo-Yu Wang, Jing-Gang Mo, Chong Jin
Kun-Peng Wang, Hao Jiang, Can Kong, Lie-Zhi Wang, Jing-Gang Mo, Chong Jin, Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
Guo-Yu Wang, Department of Radiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
Author contributions: Mo JG and Wang LZ reviewed the literature; Jiang H and Kong C collected the patient’s clinical data; Wang GY contributed to image collection; Wang KP and Jin C were responsible for the drafting and revision of the manuscript; all authors issued final approval for the version to be submitted.
Supported by Project of Taizhou Science and Technology Department, No. 1701KY36; Project of Taizhou University, No. 2018PY057; Project of Taizhou Central Hospital, No. 2019KT003.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chong Jin, Associate Professor, Surgeon, Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), No. 999 Donghai Avenue, Jiaojiang District, Taizhou 318000, Zhejiang Province, China. 13757689065@163.com
Received: April 2, 2020
Peer-review started: April 2, 2020
First decision: April 29, 2020
Revised: May 1, 2020
Accepted: July 15, 2020
Article in press: July 15, 2020
Published online: August 6, 2020
Processing time: 125 Days and 21 Hours
Abstract
BACKGROUND

Adult duodenal intussusception rarely occurs, and the majority of duodenal adenomas are located in the descending part of the duodenum. Therefore, adenomas in the horizontal part of the duodenum presenting as duodenal intussusception in adults are extremely rare.

CASE SUMMARY

A 36-year-old man complained of abdominal pain for 13 d. Blood analysis showed anemia. Magnetic resonance cholangiopancreatography and computed tomography revealed a tumor in the horizontal part of the duodenum as the main finding, leading to duodeno-duodenal intussusception. No obvious abnormalities were found on endoscopy or upper gastrointestinal radiography. He was diagnosed with duodenal intussusception secondary to duodenal adenoma. Laparotomy showed duodeno-duodenal intussusception and a tumor in the horizontal part of the duodenum near the ascending part. Postoperative pathology revealed tubular-villous adenoma with low-grade glandular intraepithelial neoplasia (local high-grade intraepithelial neoplasia). He was discharged without complications.

CONCLUSION

This case highlights that rational use of computed tomography, magnetic resonance cholangiopancreatography, endoscopy and upper gastrointestinal radiography for preoperative diagnosis and timely surgery is an effective strategy for the treatment of adult duodenal intussusception with duodenal masses.

Keywords: Adult duodenal intussusception; Duodenal adenoma; Horizontal part of the duodenum; Intestinal obstruction; Case report

Core tip: Adult duodenal intussusception is a challenging disease because of its extremely rare occurrence and nonspecific clinical manifestation, and the differential diagnosis should include digestive tract obstruction and pancreatitis. Here, we present a case of adult duodeno-duodenal intussusception with horizontal adenoma near the ascending part of the duodenum to elucidate and review the pathogenesis, presentation, diagnosis and consensus recommendations of duodenal intussusception. This case highlights the rational use of computed tomography, magnetic resonance cholangiopancreatography, endoscopy and upper gastrointestinal radiography for preoperative diagnosis. Timely surgery is an effective strategy for the treatment of adult duodenal intussusception with duodenal masses.