Intussusception secondary to inflammatory myofibroblasts tumor of the small intestine. case report

ABSTRACT

ABSTRACT Introduction: Intussusception occurs when part of the intestine slides into an adjacent intestinal segment. Inflammatory myofibroblast tumor is a rare cause of this condition, and is observed in 5% -16% cases in adults. Case presentation A 41-year-old woman presented with abdominal pain and distension. A exploratory laparoscopy was performed, finding ileocolic intussusception into the transverse colon. Due to uncontrollable bleeding, the procedure was converted to laparotomy; resection and latero-lateral ileocolic anastomosis were performed. Histopathology reported inflammatory myofibroblastic tumor, with a favorable postoperative evolution. The patient was discharged on the sixth postoperative day. Discussion: When located in the small intestine, 57% of the tumors that cause intussusception are benign, including the myofibroblastic tumor in this patient. The symptoms and signs associated with this neoplasm are cramp-like abdominal pain, nausea and vomiting. Although imaging studies may lead to suspect this diagnosis, in most cases it is made intraoperatively. Surgical resection of the affected intestinal segment is curative, with favorable prognosis. Conclusions: This case is considered as a rare cause of intussusception. It had a benign course and is still under study since its patho-physiology has not been fully understood.

RESUMEN

RESUMEN Introducción. Se denomina intususcepción a la introducción de un segmento intestinal a otro distal, siendo esta la causa posterior del tumor miofibroblástico inflamatorio en el 5-16% de los adultos. Presentación del caso. Paciente femenino de 41 años con presencia de dolor y distensión abdominal. Se practica exploración quirúrgica laparoscópica, observando intususcepción ileocólica hasta colon transverso. Por sangrado no controlable se realiza conversión a laparotomía, se reseca y se realiza anastomosis ileocólica latero-lateral. La histopatología reporta tumor miofibroblástico inflamatorio, con evolución postquirúrgica favorable. Se da de alta al sexto día postquirúrgico. Discusión. En el intestino delgado, 57% de los tumores que originan intususcepción son benignos, como el tumor miofibroblástico que presentó la paciente reportada. Los síntomas y signos de esta neoplasia son dolor abdominal tipo cólico, náusea y vómito. Aunque los estudios de imágenes pueden dar una sospecha del diagnóstico, en la mayoría de los casos se hace intraoperatorio. La resección quirúrgica del segmento intestinal afectado es curativa, con pronóstico favorable. Conclusiones. El presente caso representa una causa poco frecuente de intususcepción intestinal, de curso benigno, la cual continúa en estudio ya que no se ha logrado entender por completo su fisiopatología.