Omar Alkasabrah, MD1, Abdullah Hafeez, MD1, Sameeha Ibrahim, MD2, Jatin Thukral, MD1, Hamza Ansari, MD3, Muhammad Qasim Chaudhry, MD1, Faiza Jajja, MD1 1Landmark Medical Center, Woonsocket, RI; 2Jordan University of Science and Technology, Al Ramtha, Irbid, Jordan; 3NYMC St. Mary's and St. Clare, Denville, NJ Introduction: Gastrogastric intussusception is a rare entity in adults, occurring when the stomach telescopes into itself, most often due to an identifiable lead point such as a polyp or tumor. While intussusception commonly affects the small or large intestine, gastric involvement is uncommon and typically presents in older females. We report a rare case of spontaneous gastrogastric intussusception associated with small bowel obstruction in a patient with short bowel syndrome, highlighting a transient, non-neoplastic etiology.
Case Description/
Methods: A 67-year-old woman with a history of multiple small bowel obstructions, prior abdominal surgeries, and short bowel syndrome presented with acute-onset colicky epigastric pain, nausea, and bilious vomiting. She reported no flatus and one loose bowel movement the day before, consistent with her baseline. She was hemodynamically stable, with epigastric tenderness but no distension. Bowel sounds were present in the upper quadrants. CT imaging revealed a small bowel obstruction with a transition point near the umbilicus, and a proximal gastric invagination suggestive of gastrogastric intussusception. Labs were unremarkable except for mildly elevated ALT (44 U/L); lactate was normal. She was managed conservatively with NPO, IV fluids, pain control, and antiemetics. GI and surgery were consulted. EGD showed no active intussusception but revealed mild gastritis with small antral erosions and no mass. Her symptoms resolved without intervention. The intussusception was presumed to be transient, secondary to increased intra-abdominal pressure from the obstruction. Discussion: Gastrogastric intussusception is exceedingly rare, with only 22 cases reported in the literature between 1950 and 2024. Our case stands out as one of only two documented instances of gastrogastric intussusception in the setting of small bowel obstruction without an anatomical lead point. This case highlights the importance of recognizing non-neoplastic, pressure-mediated etiologies, particularly in patients with altered gastrointestinal anatomy and motility. Radiologic imaging is pivotal in diagnosis, with CT showing classic signs such as the “target” or “pseudokidney” appearance. While adult intussusception often warrants surgery, our patient improved with conservative management alone. This highlights the potential role of non-operative strategies in carefully selected cases. Given her recurrent obstructions, vigilant follow-up remains crucial.
Disclosures: Omar Alkasabrah indicated no relevant financial relationships. Abdullah Hafeez indicated no relevant financial relationships. Sameeha Ibrahim indicated no relevant financial relationships. Jatin Thukral indicated no relevant financial relationships. Hamza Ansari indicated no relevant financial relationships. Muhammad Qasim Chaudhry indicated no relevant financial relationships. Faiza Jajja indicated no relevant financial relationships.
Omar Alkasabrah, MD1, Abdullah Hafeez, MD1, Sameeha Ibrahim, MD2, Jatin Thukral, MD1, Hamza Ansari, MD3, Muhammad Qasim Chaudhry, MD1, Faiza Jajja, MD1. P6341 - The Stomach Within Itself: A Rare Case of Gastrogastric Intussusception in a Patient With Short Bowel Syndrome, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
