What’s Your Diagnosis?
An uncommon cause of recurrent duodenal intussusception
A49-year-old woman was admitted to our hospi- tal with a 1-year history of intermittent black stool and epigastric pain. She occasionally ex- perienced itchy skin and yellow sclera. Physical examination was unremarkable. Except for the decrease of hemoglobin values down to 76 g/L,
What is the diagnosis?
all other laboratory values were within the normal lim-
its. Endoscopy before admission showed a long, friable,
ulcerated, pedicle-like structure with granular surface on
the distal end, extending from the duodenal bulb into the
second part of duodenum (Figure A). Axial computed to-
mography (CT) done 2 months previously showed a prox-
imal jejunal mass and on the next day contrast-enhanced
CT showed a mass in the second portion of duodenum,
suggesting duodenal intussusception and spontaneous
resolution (Figures B, C). Subsequent abdominal CT on
admission revealed a duodenal hypodense mass with
intussusception involving the duodenum and proximal
jejunum (Figure D). No adenopathy, ascites, or other mass
lesions were noted. n
Dr. Zhao is in the department of internal medicine, and Dr. Li
and Dr. Cao are in the department of radiology at the First
Hospital of Jilin University, Changchun, China.
Published previously in Gastroenterology (2014;146:e10-e11)
By Huiying Zhao, M.D., Ye Li, M.D., and Dianbo Cao, M.D.
See The Answer on page 18