Adult intussusception is an uncommon diagnosis, usually associated with a structural lead point such as a neoplasm or adhesion. Gastrostomy tube-related intussusception is an exceedingly rare occurrence, with only sporadic cases reported in the literature. We describe the case of a 50-year-old, bed-bound woman with multiple comorbidities who presented to the emergency department with abdominal distension, tachycardia, and laboratory abnormalities, including marked leukocytosis and transaminitis. Computed tomography of the abdomen revealed a long-segment intussusception with the gastrostomy tube balloon lodged in the distal duodenum/early jejunum, as well as distension of the stomach and unexpected fluid and air in the vaginal vault. The patient’s evaluation was further complicated by findings of multifocal pneumonia. This case illustrates the diagnostic and management challenges of tube-induced intussusception in an adult, highlights the importance of considering alternative explanations such as ileus, constipation, or gastroparesis that may delay recognition, and emphasizes the need for vigilance in vulnerable, nonverbal patients.
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