Vanek's tumor as an unusual cause of ileo-ileal intessuception – A unique case report. (August 2018)

• Record Type: Journal Article
• Authors: Jan, Zaka Ullah; Muslim, Muhammad; Ullah, Kaleem; Shoaib, Azam; Ahmed, Nisar; Khan, Zainab Mahsal; Aurangzeb, Mahmud
• Is Part Of: Annals of medicine and surgery. Volume 32(2018)
• Page Start: 14
• Page End: 17
• Publication Date: 2018-08
• Subjects: Vanek's tumor -- Inflammatory fibroid polyp -- Ileo-ileal -- Intussusception; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2018.06.006
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background and aim: Vanek's tumor is a rare solitary lesion that is non-neoplastic, and arises from the submucosa of the gut. The most commonly affected sites are the stomach and the ileum [1]. IFP causing intestinal obstruction is uncommon and that ileo-ileal intussusception has been reported in the literature rarely. We present a case of an ileo-ileal intessuception in a patient who presented with acute on chronic pain abdomen and anorexia. CT abdomen & pelvis revealed a 46 × 36 mm intraluminal mass in the left iliac fossa causing ileo-ileal intussusception. Case presentation: A 60 years old gentleman was brought to the A&E with a history of intestinal obstruction. He was examined and admitted to the surgical unit. CBC revealed unique feature of reactive thrombocytosis apart from a low hemoglobin and a raised TLC. His CT scan demonstrated findings of ileo-ileal intussusception. After an informed written consent, patient underwent an exploratory laparotomy and had resection and anastomosis of the bowel. Histopathology of the specimen revealed findings compatible with IFP. Patient made an uneventful recovery post-operatively and was sent home in the next few days. On follow-up, the patient was doing well and had no complaints of abdominal pain or anorexia. Conclusion: Vanek's tumor although a rare entity, should be considered in each case of acute abdomen and physicians and surgeons need to have a high degree of suspicion in such cases. Moreover, IFP can cause reactive thrombocytosis that gets resolved after a post-operative period of 6–8 weeks. Highlights: IFP is a rare entity. Most commonly involves the gastric antrum and ileum. Presents as an acute abdomen. They can cause reactive thrombocytosis. CT scan is helpful in the diagnosis. The preferred treatment is operative resection.