Rare etiology of colonic intussusception involving an adult with emphysematous cystic enteropathy: A case report and review of literature

Abstract

BACKGROUND

Pneumatosis cystoides intestinalis (PCI), characterized by a collection of gas-filled cysts in the intestinal wall, is an uncommon but well-known condition in gastroenterology. Abdominal pain is the most frequent symptom associated with PCI. Intussusception represents a potential cause of recurrent abdominal pain or emergency presentation. However, the occurrence of colonic intussusception secondary to PCI is very unusual in adulthood.

CASE SUMMARY

A 52-year-old male, known with idiopathic PCI, presented seventeen months after initial diagnosis with a new right upper quadrant pain. A computed tomography-scan demonstrated a colonic intussusception at the hepatic flexure. PCI did not progress compared with initial investigation. The patient underwent an emergency right hemicolectomy.

CONCLUSION

Resection was recommended in this case because PCI proved to be persisting with no identified curable cause. Surgery allowed to address the underlying pathology, the potential relapse of intussusception, and the likely cause of recurrent abdominal pain, either invagination or PCI itself.

Keywords: Pneumatosis cystoides intestinalis; Colonic intussusception; Colonic obstruction; Colonoscopy; Case report

Core Tip: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by a collection of gas-filled cysts in the intestinal wall with various possible causes, such as constipation. Intussusception secondary to PCI in adult population has been rarely reported before. PCI may be a cause of intussusception similar to any tumor acting as a leading point. However, in the particular situation of intussusception caused by PCI, resection should be recommended to address this possible recurrence of abdominal pain, specifically if the underlying etiology of PCI is deemed irreversible.