Rare "ileum-ileum-colon type" adult intussusception caused by Meckel's diverticulum inversion: A case report

Rationale:Ileum-ileum-colon intussusception constitutes a small proportion of the classification of intussusception. Both adult intussusception and Meckel's diverticulum are rare clinical entities, with few reports documenting Meckel's diverticulum inversion leading to ileum-ileum-colon intussusception in adults.Patient concerns:A 33-year-old Chinese male presented with intermittent abdominal pain persisting for 1 month, that had intensified over the preceding day.Diagnoses:Abdominal computed tomography revealed intussusception, suspected to be secondary to a small intestinal lipoma.Interventions:Emergency laparotomy was performed, during which the ileum, located approximately 70 cm from the ileocecal region, was found to be invaginated into the terminal ileum and subsequently into the ascending colon, reaching the hepatic flexure. An inverted Meckel's diverticulum was at the forefront of the intussusception. Surgical resection of the diverticulum, terminal ileum, and cecum was performed, followed by an end-to-side anastomosis of the ileum and colon.Outcomes:The patient was discharged on postoperative day 7 without complications. During a 1-month follow-up, the patient reported no discomfort and exhibited normal bowel movements.Lessons:Adult intussusception of the "ileum-ileum-colon type" resulting from inverted Meckel's diverticulum is exceedingly rare and poses challenges for preoperative diagnosis. Prompt surgical intervention can lead to favorable outcomes in patients. During surgery, the initial step should involve attempting reduction of the intussusception while ensuring that the intestine is preserved as much as possible to maintain intestinal function.