Jejunojejunal Intussusception Causing Small Intestine Obstruction as the Single Presentation of Amyloidosis: A Uniqueness Report

Abstract

A group of diseases resulting from the abnormal aggregation of amyloid fibrils, mainly in the extracellular spaces of tissues, is known collectively as amyloidosis. Clinical presentations of gastrointestinal (GI) amyloidosis are mainly GI bleeding, malabsorption, protein-losing enteropathy, and dysmotility. Here, we describe an 87-year-old woman presenting with acute onset of sharp, constant, and non-radiating epigastric pain that was accompanied by nausea or vomiting. After a thorough investigation, we finally found an isolated jejunojejunal intussusception by laparotomy. The pathological study revealed massive small bowel involvement by amyloidosis in immunostaining. To our knowledge, this is the first report of small intestinal obstruction resulting from intussusception due to intraluminal amyloid polypoid nodules, as the first presentation of light-chain amyloidosis. Amyloidosis should be considered in old patients with intraluminal masses of the proximal small bowel.