Early postoperative ileoileal intussusception following adhesiolysis and enterouterine fistula resection in an adult: a rare case report.

Adult intussusception is a rare cause of intestinal obstruction and is typically associated with an underlying pathological lead point. Postoperative intussusception without an identifiable lesion is particularly uncommon and may present diagnostic and therapeutic challenges. We report the case of a 44-year-old woman who developed epigastric pain, nausea, and vomiting on postoperative Day 3 following small bowel resection and enterouterine fistula excision for adhesive bowel obstruction. Contrast-enhanced abdominal computed tomography demonstrated a 20-cm ileoileal intussusception with a characteristic bowel-within-bowel appearance and no identifiable lead point. Urgent surgical re-exploration confirmed ileoileal intussusception ~60 cm proximal to the previous anastomosis. The bowel was viable, and successful manual reduction with adhesiolysis was performed without resection. This case highlights the importance of considering postoperative intussusception in adults presenting with early postoperative bowel obstruction and supports bowel-preserving management in selected patients with viable bowel and no suspicious lesion.