eP07 Small Bowel Intussusception in an Adult Male with a Large Jejunal Polyp as a Lead Point: A Rare Presentation

Introduction Small bowel intussusception in adults is an uncommon presentation that could be initiated by small bowel polyps. This case report highlights an adult patient diagnosed with jejunojejunal intussusception caused by a large jejunal polyp as the lead point. Case presentation We present a case of a 59-year-old male who arrived at the emergency department with severe abdominal pain and belching. Additionally, he reported a two-day history of anorexia and four days of constipation. Initially, his symptoms were suspected to be gallbladder-related; however, an abdominal ultrasound showed no gallstones or inflammation. A subsequent contrast-enhanced CT scan revealed jejunal intussusception without small bowel obstruction, as well as another distal segment with possible less severe telescoping. The lead point could not be visualized or excluded on the CT scan. After senior review, an exploratory laparotomy was done and the intussuscepted jejunal segment was identified approximately 20 cm from the duodenojejunal (DJ) flexure, with 10 cm of the bowel length telescoped. No additional distal segments were telescoped as previously described on the CT scan. Reduction of the intussusception was performed, and a large 3 cm pedunculated polyp with a base at the antimesenteric border of the bowel was identified as the lead point. A wedge-shaped incision was made to excise the polyp, and the enterotomy was closed in two layers. Recovery afterwards was uneventful.