title: Epigastric pain…it's not always alcohol! An unusual presentation of caecal intussusception.
abstract: Our patient is a 19-year-old man who presented to the emergency department after consuming 50-60 units of alcohol over a weekend. He presented with a 2-day history of right-upper quadrant (RUQ) and epigastric pain radiating to the back. On examination he was haemodynamically stable. His abdomen was soft with minimal tenderness in the RUQ, epigastric and right-iliac fossa areas. Laboratory results showed a slightly raised erythrocyte sedimentation rate. Amylase and white cell count were normal. Ultrasound was performed raising the suspicion of intussusception. A CT scan was recommended and confirmed the presence of an intussusception. Once diagnosis was established, the patient had an emergency laparotomy and right hemicoloectomy, with per-operative findings consistent with the CT findings. This case illustrates the importance of keeping an open approach to all differentials while considering a diagnosis along with the importance of recognising intussusception when it occurs as complications can each represent a cause of mortality on their own.
authors.affiliation: Department of Surgery, Sligo Regional Hospital, Sligo, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Doherty
authors.affiliation: Department of Surgery, Sligo Regional Hospital, Sligo, Ireland.
authors.forename: I
authors.initials: I
authors.lastname: Ahmed
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002429:Cecal Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D003082:Colectomy / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D007443:Intussusception / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult