International Surgery Journal | October-December 2016 | Vol 3 | Issue 4 Page 2272 International Surgery Journal Law YY et al. Int Surg J. 2016 Nov;3(4):2272-2276 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Case Report A case of retrograde jejuno-duodenal intussusception caused by jejunal lipoma: a case report and review of literature Yi Ying Law 1 , Lingxiang Ye 2 * INTRODUCTION Intussusception is defined as the telescoping of a segment of the gastrointestinal tract (the intussusceptum) within the lumen of the adjacent segment (the intussuscipiens). 1 Adult intussusception is a rare entity, representing 5% of all cases of intussusception and accounts for 1%-5% of intestinal obstruction in adults. 2 There are two types of intussusception- anterograde intussusception and retrograde intussusception. 1 Anterograde intussusception is more common than retrograde intussusception, and it is classified according to location (enteroenteric, ileocolic, ileocecal, or colocolic) and cause (benign, malignant or idiopathic). 2 In adult intussusception, it can be further classified based on the presence of a lead point. 2 In adults, most of the intussusception is caused by a lead point and require surgery, whereas in the pediatric population most of it is primary and benign, and it is treated by either pneumatic or hydrostatic reduction. In adult intussusception with a lead point, benign tumor constitutes majority of the cases observed in the small intestine, whereas in colon it is commonly associated with malignancy. 3 Retrograde intussusceptions are extremely rare and represent 1% of all types of intussusception 1 . It is an anti- peristaltic invagination of a distal bowel lead point through a more proximal segment of bowel, and it is most commonly reported after gastric resection and gastrojejunostomy. 4 It is believed to be caused by altered peristalsis in focal areas, leading to dysrhythmic contractions and causing retrograde intussusception. 5 However, the exact mechanism triggering retrograde intussusception is not known. The presentation of retrograde intussusception varies with location, presenting with acute esophageal obstruction in gastro- esophageal intussusception, to symptoms of acute pancreatitis seen in jejuno-duodenal intussusception. 6,7 A ABSTRACT Adult intussusception is a rare entity, comprising 5% of all cases of intussusception. The presentation of adult intussusception commonly varies, ranging from chronic abdominal pain to acute presentation mimicking symptoms of bowel obstruction. This report describes a case of retrograde jejuno-duodenal intussusception in a 48-year old healthy male with a history of several episodes of diffuse abdominal pain and an acute episode of melena of 3 days duration. Examination revealed a soft, nondistended abdomen with palpable mass at upper abdomen associated with tenderness on palpation. Computed tomography scan findings revealed a 10cm length of jejuno-duodenal intussusception likely secondary to a jejunal lipoma. Exploratory laparotomy revealed resolved intussusception secondary to a lipoma which was treated with segmental intestinal resection. In this case report, we describe a rare case of retrograde jejuno- duodenal intussusception caused by a jejunal lipoma and performed a literature review on retrograde intussusception. Keywords: Duodenojejunal, Retrograde, Intussusception, Jejunal lipoma 1 Perdana University Graduate School of Medicine, Serdang, Malaysia 2 Sinai Hospital of Baltimore, Baltimore, USA Received: 29 June 2016 Accepted: 05 August 2016 *Correspondence: Dr. Lingxiang Ye, E-mail: lye@lifebridgehealth.org Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20163611