Clinical & Medical Case Reports

Intestinal intussusception in adults is not considered to be common. It is usually encountered in children, in whom, it is generally considered idiopathic. In contrast, adults presenting with intussusception generally possess a demonstrable pathological lead point; commonly a polyp, submucosal lipoma or other tumors. Clinical presentations may range from an acute presentation to a chronic one and such wide variations make it challenging to establish the diagnosis on time. But the use of computed tomography (CT) in these scenarios has considerably enhanced the diagnostic capabilities. Th ough a conservative approach might be preferred in some circumstances, these patients usually require surgery, especially when the viability of the involved bowel is compromised. Our patient, a 42-year-old male, presented to us with clinical features suggestive of acute intestinal obstruction. X-ray abdomen showed multiple air-fl uid levels. CT of the abdomen showed diffuse dilatation of the jejunal and ileal loops and the collapse of the large bowel with a transition point probably at the terminal ileum or ileocaecal junction. Following this, he underwent an emergency laparotomy when intussusception of the ileum was noted and the involved bowel segment was resected. Histopathology showed that the lead point was due to tuberculous lesion. Further investigations showed that the patient had pulmonary tuberculosis which was unidentifi ed till then. The patient was started on anti-tuberculous treatment thereafter. We intend to present this case to sensitize the readers to the unusual presentation of intestinal tuberculosis as intussusception which should be considered especially in countries with high tuberculosis endemicity.