Primary intussusception in pregnancy: a case report.

Background: Intussusception is a rare cause of bowel obstruction in adults, typically associated with malignancy, granuloma formation, a foreign body or an anatomic defect.

Case: A 21-year-old, primiparous woman presented at 33 5/7 weeks' gestation with vague abdominal symptoms consistent with acute viral gastroenteritis. She did not improve with conservative measures. A presumptive diagnosis of severe preeclampsia was made based on elevated blood pressure, abnormal liver function tests and epigastric pain. Labor was induced 34 5/7 weeks' gestation. The patient did not improve after an uncomplicated vaginal delivery. Abdominal radiographs and computed tomography were consistent with intussusception. Surgical findings were consistent with the radiologic findings. The patient underwent a right hemicolectomy with stapled anastomosis. No pathologic or anatomically anomalous lead point was identified intraoperatively or on final pathology.

Conclusion: Intussusception is a rare finding in the peripartum period, often presenting with vague abdominal symptoms and mistaken for benign obstetric and nonobstetric diseases. This case is only the second one of adult perinatal intussusception without an anatomic or pathologic lead point.