Adult
intussusception is rare, highly associated with a malignant lead point, and
often requires emergent surgical management. We report the case of a
44-year-old male who presented with generalized abdominal pain and was found to
have early ileocolic intussusception secondary to a large ileocecal mass.
Biopsies of the mass andan
enlarged cardiophrenic lymph node, as well as pleural fluid cytology were all
consistent with Burkitt lymphoma (BL). Curiously, the patient’s abdominal exam
was reassuring, and the intussusception and malignant bowel obstruction
resolved over 36 hours with conservative management alone. With a Burkitt
lymphoma international prognostic index (BL-IPI)
score of 2, the patient proceeded to treatment withcombination chemoimmunotherapy and attained a complete response after
four cycles. There was no bowel perforation or recurrent intussusception
throughout treatment. Thus, this report marks the first reported case of adult BL-associated intussusception to resolve with non-invasive
managementand
establishes a precedent for conservative management in select patients.
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