Système gastro-intestinal et digestif

Abstrait

A Case Report on Post-Operative Intussusceptions in Adult

Yitagesu Aberra*

Intussusception is the prolapse of one part of the bowel into the lumen of the immediately adjoining part. Intussusceptions in adults are much less common, representing 5% of all intussusceptions, 1% of all bowel obstructions, and 0.08% of all abdominal surgery. Surgery as a possible cause of intussusceptions in children is very rare (0.05%) and in adult, there are very few reports. In a report in a mayo clinic only 73 cases were seen within 23 year. This case report will be one of the few case reports on the subject matter. This is a 30 year old female from rural areas who underwent laparotomy and cystectomy for the diagnosis of left side ovarian cystic torsion after she presented with right side abdominal pain of sixth days duration which was squeezing in type. On the fourth post-operative day she started to have abdominal distention, and vomiting which was non projectile bilious matter 4-5 times/day. She came after 4 days of these symptoms with failure to pass both feces and flatus. On the day of admission she has 3-4 episodes of watery diarrhea which was blood tingled. Physical examination she was acutely sick looking and dehydrated. Abdominally she has centrally distended abdomen with palpable bowel loops and visible peristalsis. We investigated her with abdominal X-ray and ultrasound which suggested SBO 2ry to intussusceptions. After stabilizing the patient we did laparotomy. Intraoperativly we found viable ileo- ileal intussusceptions at two sites with distended bowel loops proximal and collapsed bowel loops distal to the intussusceptions. She had smooth post op course and discharged improved. The case is extremely important for the study of this possible differential in post-operative period because a delayed or incorrect diagnosis of acute intussusceptions can have serious consequences. Moreover it serves as an input for future studies in the area.