Duodenoduodenal intussusception: two case reports with different lead points


  • Rutu A. Brahmbhatt Department of General Surgery, Smt Municipal Medical College, Ahmedabad, Gujarat, India
  • Drupad G. Patel Department of General Surgery, Smt Municipal Medical College, Ahmedabad, Gujarat, India
  • Pranav B. Chaudhary Department of General Surgery, Smt Municipal Medical College, Ahmedabad, Gujarat, India




Duodenoduodenal intussusception, Tubulovillous adenoma, Juvenile hamartomatous polyp (Peutz-Jeghers polyposis), Intussusception lead points, Target sign, Contrast-enhanced computed tomography


Intussusception occurs when one portion of the bowel invaginates into an immediately adjacent segment, almost invariably it is the proximal into the distal. Duodenoduodenal intussusception is a rare condition that is in general caused by a tumour either benign or malignant. However duodenal intussusception is an extremely rare entity as duodenum is a fixed retroperitoneal structure. The lead point of intussusception is usually a Meckels’s diverticulum, a Peutz-Jeghers polyp or intestinal adenomas. We describe two case reports of duodenoduodenal intussusception secondary to a tubulovillous adenoma and juvenile hamartomatous polyp ((Peutz Jegher’s polyposis) that caused intussusception in a 17-year-old female and 11-year-old male respectively. Both cases had underlying abnormalities acting as lead points with different etiologies. We resected the tumour mass from both patients successfully. This report describes the rare case of isolated adenoma of the 3rd part of the duodenum and Peutz Jegher polyp in the jejunum presented as duodenoduodenal and duodenojejunal type of enteroenteric intussusception fully treated by segmental resection of the duodenum and jejunum and doing well on follow up.


Azar T, Berger DL. Adult intussusception. Ann Surg. 1997;226(2):134-8.

cRae JE, Quinn HE, Saravanos GL, McMinn A, Britton PN, Wood N, et al. Paediatric Active Enhanced Disease Surveillance (PAEDS) annual report 2016: Prospective hospital-based surveillance for serious paediatric conditions. Commun Dis Intell. 2018;201;43.

Jia Y, Fu H, Li N, Kang Q, Sheng J. Diagnosis and treatment for 46 cases of Peutz-Jeghers syndrome. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018;43(12):1323-7.

Restivo V, Costantino C, Giorgianni G, Cuccia M, Tramuto F, Corsello G, et al. Case-control study on intestinal intussusception: implications for anti-rotavirus vaccination. Expert Rev Vaccines. 2018;17(12):1135-41.

Teixeira H, Hauswirth F, Römer N, Muller MK, Baechtold M. An ileo-colic intussusception reaching down to the descending colon - A case report. Int J Surg Case Rep. 2022;93:107009.

O'Connor PA, McGrath FP, Lane BE. Duodenal intussusception secondary to an internal duodenal duplication Clin Radiol. 1999;54(1):69-70.

Meshikhes AW, Al-Momen SA, Al Talaq FT, Al-Jaroof AH. Adult intussusception caused by a lipoma in the small bowel: report of a case. Surg. Today. 2005;35:161-5.

Yalamarthi S, Smith RC. Adult intussusception: Case reports and review of literature Postgrad Med J. 2005;81(953):174-7.

Reijnen HA, Joosten HJ, de Boer HH. Diagnosis and treatment of adult intussusception Am J Surg. 1989;158(1):25-8.

Ikeda K, Miyauchi K, Fujimoto A, Hayashi T, Kogure M, Ohgoshi E. A case of pedunculated tubulovillous adenoma of the duodenum. Am J Gastroenterol. 1998;93(7):1159-62.

Sakorafas GH, Friess H, Dervenis CG. Villous tumours of the duodenum: biologic characters and clinical implications. Scand J Gastroenterol. 2000;35(4):337-44.

Wilson JM, Melvin DB, Gray GF, Thorbjarnarson B. Primary malignancies of the small bowel: a report of 96 cases and review of the literature. Ann Surg. 1974;180(2):175-9.

Tameez Ud Din A, Khan AH, Bajwa H, Maqsood HM, Malik MN Clinical efficacy and safety profile of prucalopride in chronic idiopathic constipation. Cureus. 2019;11:0.

Niwa A, Kuwano S, Tomita H, Keita K, Yukiya O, Tomohiro K, et al The different pathogeneses of sporadic adenoma and adenocarcinoma in non-ampullary lesions of the proximal and distal duodenum. Oncotarget. 2017;8(25):41078-90.

Latchford A, Cohen S, Auth M, Michele S, Jerome V, Richard D, et al. Management of Peutz-Jeghers syndrome in children and adolescents: a position paper from the ESPGHAN Polyposis Working Group. J Pediatr Gastroenterol Nutr. 2019;68(3):442-52.

Rebsdorf Pedersen I, Hartvigsen A, Fischer Hansen B. Management of Peutz-Jeghers syndrome. Experience with patients from the Danish Polyposis Register. Int J Colorectal Dis 1994;9:177-9.

Loureiro J, Menegazzo GL, Vergamini L. Diagnostic difficulty in Peutz-Jeghers syndrome. J Coloproctol (Rio de Janeiro). 2015;35:67-71.

Tsou PY, Wang YH, Ma YK, Deanehan JK, Gillon J, Chou EH, et al. Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis. Am J Emergency Med. 2019;37(9):1760-9.

Goh PM, Lenzi JE. Benign tumours of the duodenum and stomach. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence‑Based and Problem‑Oriented. Munich: Zuckschwerdt; 2001. Available at: http://www.ncbi.nlm.nih.gov/books/ NBK6948/. Accessed on 24 March, 2024.






Case Reports