Sub acute intestinal obstruction - A Vanek s tumor induced ileo - ileal intussuception

Vanek’s tumor is a rare benign inflammatory fibroid polyp like localized lesions originating in the submucosa of the gastrointestinal tract. Intussusceptions due to inflammatory fibroid polyps are uncommon; moreover, ileo-ileal Intussusception presenting as subacute small bowel obstruction has rarely been reported. We report a 49-year-old man who came with complaints of indigestion, flatulence, altered bowel habits with abdominal distension for the past 11⁄2 year that aggravated since a week. Abdominal examination revealed distension, signs of intestinal obstruction. The patient underwent laparoscopic assisted resection of intussuscepted ileal segment and four-layer side to side anastomosis. Histopathological analysis showed an ulcerative lesion with variable cellularity, formed by spindle cells with small number of mitosis and an abundant inflammatory infiltrate comprising mainly eosinophils. Immunohistochemistry confirmed the diagnosis of ileal Vanek’s tumor. Although inflammatory fibroid polyps are seen very rarely in adults, they are among the probable diagnoses that should be considered in obstructive tumors of the small bowel causing Intussusceptions.