INTRODUCTION
This case reports a rare case of adult ileocolic intussusception
secondary to an inflammatory fibroid polyp (IFP). Intussusception is an
uncommon adult surgical condition, representing 5-16% of all cases of
intussusception, and only 1-5% of all causes of adult intestinal
obstruction (1). Up to 90% of cases are secondary to an underlying
pathology, with approximately 65% being secondary to benign or
malignant neoplasms (2). The diagnostic uncertainty of the underlying
lead point highlights the need to surgically intervene on these lesions
promptly.
The inflammatory fibroid polyp, which is also known as the Vanek tumour,
was first described by Vanek in 1949 and then proposed by Helwig and
Ranier in 1953 (2). It is now defined as a benign tumour arising from
the submucosa of the gastrointestinal tract. The most common site from
which IFPs arise is the gastric antrum in 66-75% of cases, followed by
the small bowel in 18-20% of cases (2). The ileal segment, however, is
the most common site where they occur. Historically, aetiology was
thought to be an inflammatory response to a submucosal granuloma usually
associated with an irritating stimulus such as Helicobacter
pylori , trauma, tuberculosis, etc. However, activating mutations of the
proto-oncogene platelet derived growth factor alpha (PDGFRA) gene have
been recently reported as a potential underlying true neoplastic origin
(3).
The appropriate surgical management of adult intussusception remains
debatable when deciding on a primary en bloc resection versus an
initial reduction followed by a limited resection. Here, we report a
case of a laparoscopic ileocolic resection.