title: Rare case of intussusception in an adult with acute myeloid leukemia.
abstract: Intussusception is rarely reported in adult patients with acute leukemia. We report a case of intussusception in a 29-year-old woman with acute myeloid leukemia (AML). She developed right lower quadrant pain, fever, and vomiting on day 16 of induction chemotherapy. Physical examination showed tenderness and guarding at the right lower quadrant of the abdomen. Abdominal computed tomography (CT) showed distension of the cecum and ascending colon, which were filled with loops of small bowel, and herniation of the ileocecal valve into the cecum. We proceeded to laparotomy and revealed ileocecal intussusception with the ileocecal valve as the leading point. The terminal ileum was thickened and invaginated into the cecum, which showed gangrenous changes. Right hemicolectomy was performed and microscopic examination of the colonic tissue showed infiltration of leukemic cells. The patient recovered after the operation and was subsequently able to continue treatment for AML. This case demonstrates that the diagnosis of intussusception is difficult because the presenting symptoms can be non-specific, but abdominal CT can be informative for preoperative diagnosis. Resection of the involved bowel is recommended when malignancy is suspected or confirmed. Intussusception should be considered in any leukemia patients presenting with acute abdomen. A high index of clinical suspicion is important for early diagnosis.
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Man Fai
authors.initials: MF
authors.lastname: Law
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Cheuk Kei
authors.initials: CK
authors.lastname: Wong
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Chun Yin
authors.initials: CY
authors.lastname: Pang
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Hay Nun
authors.initials: HN
authors.lastname: Chan
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Ho Kei
authors.initials: HK
authors.lastname: Lai
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Chung Yin
authors.initials: CY
authors.lastname: Ha
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Celia
authors.initials: C
authors.lastname: Ng
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Yiu Ming
authors.initials: YM
authors.lastname: Yeung
authors.affiliation: Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip, Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Sze Fai
authors.initials: SF
authors.lastname: Yip
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001706:Biopsy; D003082:Colectomy; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007080:Ileocecal Valve / Q000601:surgery; D007443:Intussusception / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Abdominal pain; Acute leukemia; Colon; Intussusception; Malignancy