Intussusception on a Small Bowel Gastrointestinal Stromal Tumor: A Rare Cause of Intestinal Obstruction in Adults

Acute intestinal intussusception is a rare surgical emergency in adults, especially when it involves an ileal gastrointestinal stromal tumor (GIST). An atypical clinical presentation, which may be associated with a partial or complete occlusive syndrome, a palpable abdominal mass or even melena, makes the use of radiological imaging essential, in particular CT scanning with contrast which allows the positive diagnosis of intestinal intussusception as well as identification of the organic lesion in question. Unlike children whose etiology is often idiopathic, in adults the incidence of malignant organic lesions is high. What makes the treatment of choice is complete surgical resection in one piece with healthy margins without intraoperative manual reduction. The diagnosis of GIST is confirmed by immunohistochemistry (CD117 – DOG1) or even a molecular biology search for mutations (KIT – PDGFRA). Adjuvant imatinib is essential when the risk of recurrence is intermediate or high. Rigorous monitoring to detect local and distant recurrences should not be neglected. We report the case of a 51-year-old patient admitted to the emergency room for an intestinal obstruction whose explorations concluded that it was an intestinal intussusception on an ileal GIST.