P5020 - A Rare Manifestation of Celiac Disease: Recurrent Small Bowel Jejunojejunal Intussusception

Jason John, DO¹, Brian Blair, DO², Lucy Joo, DO², Drew Chiesa, DO³, Matthew Everwine, DO³, Joshua Soliman, DO³, Neethi Dasu, DO^4
1Jefferson Health, Pennsauken, NJ; ²Jefferson Health, Cherry Hill, NJ; ³Jefferson Health, Washington Township, NJ; ⁴Beth Israel Lahey Health, Burlington, MA

Introduction: Intussusception is a rare occurrence in adults, comprising approximately 5% of total cases. Adult intussusception is caused by a structural lesion or “lead point” lesion approximately 80-90% of the time; however, it can rarely be idiopathic in nature. We present a case of a 30-year-old female with known celiac disease who presented with recurrent intussusception in the absence of a structural lesion.

Case Description/Methods: A 30-year-old female with a past medical history of Celiac Disease diagnosed in 2016 and splenic laceration following a motor vehicle accident presented for evaluation of acute onset left upper quadrant abdominal pain. She was notably admitted to the hospital 3 days prior for similar symptoms and was diagnosed with enteroenteric intussusception in the left mid abdomen based on CT imaging. She had no prior diagnosis of intussusception. She underwent repeat imaging before discharge, which revealed resolved intussusception. Upon arrival to the emergency department, CT of the abdomen and pelvis with IV contrast was performed, which showed developing short segment non-obstructed small bowel intussusception within the left mid abdomen approximately 3.8 cm in length involving the proximal and mid jejunum with adjacent small minimally enlarged mesenteric nodes. General surgery was consulted without any plan for surgical intervention. She was treated with supportive care, including intravenous fluids, bowel rest, and analgesia, and continued a strict gluten-free diet.

Discussion: This case highlights the occurrence of intussusception as a rare manifestation of celiac disease. Additionally, most cases involve the ileum folding into the cecum with an identifiable structural lesion. Our patient not only had an absence of a lead point lesion, but her intussusception involved the jejunum only. Although adult intussusception is rare, it is increasing in frequency, and thus, it is imperative that further research be conducted to investigate the association of intussusception in the setting of celiac disease in adults. Furthermore, clinicians should be aware of the association between intussusception and celiac disease to avoid unnecessary surgical intervention and facilitate prompt treatment.



Disclosures:


Jason John, DO¹, Brian Blair, DO², Lucy Joo, DO², Drew Chiesa, DO³, Matthew Everwine, DO³, Joshua Soliman, DO³, Neethi Dasu, DO⁴. P5020 - A Rare Manifestation of Celiac Disease: Recurrent Small Bowel Jejunojejunal Intussusception, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.