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Ileo-ileal intussusception in adult caused by Vanek’s tumor: a report of five cases

Mohamed S. Belhamidi, Abdelmounaim Aitali, Mohamed Tarchouli, Hicham Baba, Ahmed Bounaim, Khalid Sair.

Abstract
Background: Inflammatory fibroid polyps (IFPs) (Vanek’s tumor) are rare, benign lesions of the gastrointestinal tract. Its treatment is surgical. The debate focused on the issue of primary en bloc resection of intussuscepted bowel versus initial reduction followed by more limited resection. We report five cases of small bowel intussusception in adult caused by Vanek’s tumor.
Methods: The retrospective study reviewed epidemiological data, clinical features, diagnosis and management of adults with a diagnosis of intussusception admitted to our department from August 2010 to April 2014. Only intussusception caused by Vanek’s tumor was included in our study.
Results: There were 4 males and 1 female. Their average age was 53 years. All of them were admitted with abdominal pain. The abdominal exam revealed an abdominal distension in 4 patients and a palpable abdominal mass in 2 patients. One patient had a normal physical examination. CT demonstrated , a sign pathognomonic for ileo-ileal intussusception. All of the patients underwent surgical treatment by laparotomy for 4 patients and laparoscopy approach for 1 patient. 4 patients had an ileo-ileal intussusception; which was resected after partial reduction and followed by end-to-end anastomosis. In one case, we found an ileo-caeco-colic intussusception, which was resected and side-to-side ileo-colic anastomosis was performed. Diagnosis of Vanek’s tumor was confirmed by immunohistochemical examination. Postoperative course was uneventful.
Conclusions: The recommended treatment of adult intestinal invagination is surgical resection. Discussion continues as to whether or not a reduction has to be done before a resection.

Key words: Vanek’s tumor, Intussusception, Surgical resection



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