摘要
Adult intussusception is rare, highly associated with a malignant lead point, and often requires emergent surgical management. We report the case of a 44-year-old male who presented with generalized abdominal pain and was found to have early ileocolic intussusception secondary to a large ileocecal mass. Biopsies of the mass and an enlarged cardiophrenic lymph node, as well as pleural fluid cytology were all consistent with Burkitt lymphoma (BL). Curiously, the patient’s abdominal exam was reassuring, and the intussusception and malignant bowel obstruction resolved over 36 hours with conservative management alone. With a Burkitt lymphoma international prognostic index (BL-IPI) score of 2, the patient proceeded to treatment with combination chemoimmunotherapy and attained a complete response after four cycles. There was no bowel perforation or recurrent intussusception throughout treatment. Thus, this report marks the first reported case of adult BL-associated intussusception to resolve with non-invasive management and establishes a precedent for conservative management in select patients.
Adult intussusception is rare, highly associated with a malignant lead point, and often requires emergent surgical management. We report the case of a 44-year-old male who presented with generalized abdominal pain and was found to have early ileocolic intussusception secondary to a large ileocecal mass. Biopsies of the mass and an enlarged cardiophrenic lymph node, as well as pleural fluid cytology were all consistent with Burkitt lymphoma (BL). Curiously, the patient’s abdominal exam was reassuring, and the intussusception and malignant bowel obstruction resolved over 36 hours with conservative management alone. With a Burkitt lymphoma international prognostic index (BL-IPI) score of 2, the patient proceeded to treatment with combination chemoimmunotherapy and attained a complete response after four cycles. There was no bowel perforation or recurrent intussusception throughout treatment. Thus, this report marks the first reported case of adult BL-associated intussusception to resolve with non-invasive management and establishes a precedent for conservative management in select patients.
作者
Carla Isabel Borré
Bethany Boyle
Kelsey Lynch
Anuradha Kanaparthi
Clifford Michael Csizmar
Daniel Philip Larson
Matthew Dain Braithwaite
Isla McKerrow Johnson
Thomas Elmer Witzig
Diego Armando Suarez
Carla Isabel Borré;Bethany Boyle;Kelsey Lynch;Anuradha Kanaparthi;Clifford Michael Csizmar;Daniel Philip Larson;Matthew Dain Braithwaite;Isla McKerrow Johnson;Thomas Elmer Witzig;Diego Armando Suarez(Yale School of Public Health, Yale University, New Haven, USA;Department of Medicine, Mayo Clinic, Rochester, USA;Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA;Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, USA;Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, USA)
