Abstract
We present a case of a 36-year-old male who presented with abdominal pain and vomiting. Inflammatory markers were elevated in routine investigations, while other laboratory parameters were within normal limits. Ultrasound imaging revealed a target lesion, which required further evaluation with a CT scan and confirmed ileocolic intussusception. An exploratory laparotomy showed a solid lesion measuring 5 by 6 cm in the cecum, along with evidence of ileocolic intussusception. A standard right hemicolectomy was performed, and the postoperative course was uneventful. Histopathological examination showed an inflammatory myofibroblastic tumor with nodular hyperplasia. The report highlighted the importance of assessing rare neoplastic causes in patients with intussusception.
Keywords: Inflammatory Myofibroblastic tumor, intussusception, hemicolectomy, spindle cell proliferation, abdominal pain, vomiting
Introduction : Inflammatory Myofibroblastic tumors (IMTs) are rare neoplasms characterized by proliferative Myofibroblastic spindle cells accompanied by a prominent inflammatory infiltrate. [1] IMTs predominantly affect children and young adults but can occur at any age. [2] The most common site of occurrence is the lung, followed by the extrapulmonary sites like liver, pancreas, intestine, and bones [3]. Intestinal involvement is relatively rare, and ileocolic intussusception caused by IMT is an even rarer presentation [4]. We report a case of a 36-year-old male who presented with abdominal pain, vomiting, and subsequent diagnosis of IMT leading to ileocolic intussusception.
Case presentation: A 36-year-old male presented to the emergency department with a three-day history of diffuse abdominal pain, followed by vomiting. The pain started from the right lower quadrant and later generalized. On physical examination, mild tenderness was present on deep palpation in the right lower quadrant of the abdomen. The patient had no significant medical history and denied any recent weight loss or changes in bowel habits.
Laboratory investigations revealed raised inflammatory marker.  A complete blood count revealed elevated WBCs (17,100/µL) with neutrophilia (80%). Blood urea nitrogen and creatinine level were normal and other hematological and biochemical parameters were within normal limits. An ultrasound examination of the abdomen showed a target lesion in the right lower quadrant, raising the suspicion of intussusception. A subsequent CT scan confirmed segmental, circumferential thickening of the terminal ileocolic junction showing a target stratification pattern (Fig 1) . The protrusion of terminal ileum into ascending colon gave an intraluminal pseudomass appearance (Fig 2) . The small bowel loops proximal to ileocolic junction was dilated with outer-to-outer diameter of 3.2cm and mottled appearance giving small bowel feces sign.