Intussusception and Chronic Marijuana Use in a Young Adult

Patient: Female, 26-year-old Final Diagnosis: Intussusception Symptoms: Abdominal pain • nausea Medication: — Clinical Procedure: CT scan • surgery Specialty: Gastroenterology and Hepatology • General and Internal Medicine • Surgery OBJECTIVE: Unusual clinical course BACKGROUND: Intussusception is a common phenomenon in children, but it is rare in adults. In the pediatric population, the presentation is commonly primary, without a lead point. However, up to 90% of intussusception cases arise due to a secondary cause – a pathological lead point – which the most common etiology in adults being malignancy. Herein, we present a case report of adult intussusception without a known cause. CASE REPORT: A 26-year-old woman presented to the hospital with severe abdominal pain. She admitted to not passing stool or gas for 2 days. The patient’s social history was significant for chronic marijuana use. A computed tomography (CT) scan of the abdomen revealed a 6-cm in length intussuscepted segment of bowel in the descending colon distal to the splenic flexure with no obvious inciting mass. The patient was sent for emergent open abdominal surgery. Upon surgical exploration, the surgeons discovered that the intussusception had self-resolved. Aside from a small ball of stool, an intraoperative colonoscopy revealed no masses or polyps. CONCLUSIONS: Marijuana use is known to disrupt gastrointestinal (GI) mobility through receptors in the GI tract nerve plexuses. The incidence of chronic marijuana use and adult intussusception is documented in the literature. Conservative management with bowel rest is confirmed to be a suitable treatment option with a favorable outcome. Therefore, we present this case to increase awareness of the potential adverse effects of chronic marijuana use, and to prevent invasive treatment.