A Rare Presentation of Cecal Adenocarcinoma Causing Adult Ileocolic Intussusception: A Case Report

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Intussusception occurs when a segment of the bowel telescopes into an adjacent segment, potentially leading to obstruction and intestinal ischemia. Intussusception in adults is likely caused by a pathological lead point (PLP), and it can be challenging to diagnose due to its broad clinical presentation, which requires a high degree of clinical suspicion. This case report describes a rare presentation of cecal adenocarcinoma in a young patient that caused ileocolic intussusception. A 31-year-old woman presented to the emergency department with progressively worsening intermittent abdominal pain, nausea, and bloating. She denied fever, chills, vomiting, hematochezia, and unintentional weight loss. Computed tomography (CT) scan of the abdomen and pelvis suggested ileocecal intussusception and two irregular cystic masses in the liver. After a colonoscopy showed a necrotic intraluminal mass, the patient underwent an exploratory laparotomy with right hemicolectomy due to the high risk of malignancy-associated intussusception. Pathology results from the hemicolectomy were consistent with adenocarcinoma of colonic origin. Furthermore, a liver biopsy was conducted to confirm metastases. The recovery was uncomplicated, with a gradual return of bowel function and tolerance of oral intake. A central venous port was placed for anticipated systemic chemotherapy, and the patient was referred for outpatient oncology follow-up, including positron emission tomography (PET)-CT imaging and initiation of chemotherapy. This case highlights the importance of considering colorectal malignancy in the differential diagnosis of young adults presenting with nonspecific gastrointestinal symptoms. Early diagnosis with high-contrast CT imaging is critical for identifying intussusception, evaluating for PLPs, and detecting metastatic disease, while prompt surgical intervention remains essential given the rarity of adult intussusception and the high likelihood of an underlying malignant etiology.

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