RESUMO
Eosinophilic gastroenteritis (EG) is a rare disease characterised by abnormal eosinophilic infiltration of the gastrointestinal tract. We describe a case of EG presenting as an intestinal obstruction in a patient with rheumatoid arthritis (RA). A 54-year-old man with RA presented to the emergency department with abdominal pain and vomiting. On examination, his abdomen was distended and tender. Laboratory data showed leucocytosis with raised inflammatory markers and without eosinophilia. CT revealed dilated small bowel loops, with a couple of loops forming a mass and abscess formation. Emergency laparotomy was performed with segmental resection of the ileum and side-to-side anastomosis. Histology confirmed the diagnosis of EG. The patient recovered well and was asymptomatic at the time of writing this report.
Assuntos
Artrite Reumatoide/complicações , Enterite/complicações , Eosinofilia/complicações , Gastrite/complicações , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Enterite/diagnóstico , Eosinofilia/diagnóstico , Gastrite/diagnóstico , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/cirurgia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
INTRODUCTION: Intussusception is rare in adults and can have acute, intermittent or chronic presentations. We present an unusual case of intussusception in an adult. PRESENTATION OF CASE: A 25 year old male presented with sudden severe abdominal pain and vomiting. He had no relevant medical history. Mechanical small bowel obstruction was confirmed on imaging and laparotomy revealed a nodular lead point in the submucosa of the ileum. He had resection of a segment of small bowel with a primary anastamosis. Histopathology of the lesion demonstrated myoepithelial hamartoma (MEH), a rare cause of intussusception. DISCUSSION: Although intussusception is not uncommon in children, it is rare in adults. Management delays are a major cause of morbidity. This report details our management of a case of intussusception caused by MEH in an otherwise healthy adult. CONCLUSION: Intussusception caused by MEH is a rare but serious cause of mechanical bowel obstruction. We propose that surgeons should consider this diagnosis in atypical cases of bowel obstruction and expedite laparotomy when it is suspected.