Adult ileal intussusception: A case of primary diffuse large B-cell lymphoma

International Conference on Clinical Case Reports and Dermatology

November 08-09, 2018 Sydney, Australia

Jacqueline Hawthorne

Hunter New England Health, Australia.

Scientific Tracks Abstracts: J Clin Case Rep

Abstract :

Introduction: Intussusception is a rare cause of bowel obstruction in adults, accounting for 1-5%. Only 5% of intussusception cases occur in adults. 90% of cases in adults are due to a pathological lead point, usually Meckels diverticulum, carcinoma, polyp, colonic diverticulum or strictures, with 65% of cases in the large bowel being due to a malignant cause and 30% of cases in the small bowel due to malignancy. Primary malignant tumors of the small intestine account for less than 2% of gastrointestinal malignancies. Primary diffuse large B cell non-Hodgkinâ??s lymphoma in small intestine is even rarer. Intussusception due to primary lymphoma is extremely rare. The most common type of lymphoma causing intussusception is diffuse B-cell lymphoma Case: A 63-year-old male presented with a 6-week history of abdominal pain and vomiting. He was admitted two weeks prior at another hospital who found ileal intussusception on CT and managed conservatively. After discharge his pain and vomiting worsened and he developed obstipation, so presented to our hospital. Repeated CT confirmed ileal intussusception. At operation he was found to have both ileoileal and ileocolic intussusception due to a palpable ileal intraluminal mass. He underwent a laparotomy, right hemi colectomy and small bowel resection. There was no sign of metastasis. His histology showed high grade B-cell lymphoma likely diffuse large B-cell lymphoma in the ileum. He recovered well and was referred to oncology for ongoing management of his lymphoma. Discussion: Both intussusception and primary diffuse large B-cell lymphoma in the small intestine are rare in adults. The combination of the two is extremely rare. Intussusception in adults almost always requires surgical intervention due to the high incidence of underlying malignancy. In this case we saw a patient who was managed conservatively who did not improve. For patients with intussusception and non-Hodgkinâ??s lymphoma, the treatment of choice is primary surgical resection.

Biography :

Jacqueline Hawthorne is currently working at Hunter New England Health.

E-mail: jacqueline.hawthorne@hnehealth.nsw.gov.au