A RARE CASE OF OBTURATORY INTESTINAL OBSTRUCTION: SMALL-COLON INVAGINATION IN AN ADULT

Description of a clinical case. The article presents a rare case of obstructing adhesion – ileocolic intussusception in an adult patient. The patient had no predisposing factors for intussusception (previous surgeries on the abdominal organs, intestinal tumors). The clinical picture had an atypical course. There were no signs characteristic of acute obstructing adhesion and other acute surgical pathology. The patient was admitted to the therapeutic unit with a diag-nosis of exacerbation of chronic pancreatitis. A differential diagnosis was made between acute appendicitis, Meckel’s diverticulum and pancreatitis. Ultrasound examination of the abdominal organs revealed a ring-shaped formation in the right iliac region. A blood test showed no signs of acute inflammation. Contrast-enhanced computed tomogra-phy of the intestine also revealed a well-defined mass in the right iliac region. Repeated diagnostic studies were also carried out, which did not clarify the situation and did not give a reliable result. The clinical picture of acute obstruct-ing adhesion developed on the day 3 in hospital. The patient was consulted by a surgeon and underwent surgery, which allowed to identify the cause of the obstruction – ileocolic intussusception. Reduction of intussusception was performed, the intestine was found to be viable during exploration, but no intestinal resection was performed. 
The patient was discharged with recovery. The treatment result was assessed as good.
Conclusion. The peculiarity of this clinical observation is that the pathology is characteristic of pediatric patients. 
In adults, intussusception is extremely rare and occurs mainly in patients with intestinal tumors. Diagnosis was dif-ficult due to the atypical picture of intestinal obstruction. This clinical observation indicates the difficulties of choosing the right surgical tactics in patients with an atypical clinical picture of the disease. In such doubtful cases, diagnostic laparoscopy can be additionally included in the range of research methods.

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