Synchronous ileo-ileal and ileocolic intussusception caused by an inverted giant Meckel's diverticulum in an adult: a rare case report.

INTRODUCTION

Adult intussusception is a rare clinical entity, typically associated with a pathological lead point. Meckel's diverticulum, although the most common congenital gastrointestinal anomaly, seldom presents with complications in adulthood. Synchronous intussusception involving multiple bowel segments is exceptionally uncommon.

PRESENTATION OF CASE: A 21-year-old man presented with a 2-week history of intermittent colicky abdominal pain, abdominal distension, bilious vomiting, and constipation. Imaging revealed features of both ileo-ileal and ileocolic intussusception with small bowel obstruction. Diagnostic laparoscopy confirmed dual intussusceptions with viable bowel. Following reduction, an inverted giant Meckel's diverticulum was identified as the lead point. Segmental small bowel resection with primary anastomosis was performed. Histopathology demonstrated diverticulitis with ectopic gastric mucosa and no malignancy. The postoperative course was uneventful.

DISCUSSION: In adults, intussusception is usually secondary to an identifiable lesion, often requiring surgical management. Meckel's diverticulum may act as a lead point, particularly when inverted, mimicking an intraluminal mass. Preoperative diagnosis is challenging due to nonspecific symptoms; however, computed tomography plays a crucial role in detection and surgical planning. Synchronous intussusception in adults is extremely rare and typically underreported.

CONCLUSION

This case highlights a rare presentation of synchronous ileo-ileal and ileocolic intussusception caused by an inverted giant Meckel's diverticulum. Early recognition and prompt surgical intervention are essential to prevent complications and ensure favorable outcomes.