# Iatrogenic Intussusception Due to Gossypiboma Presenting as Acute Intestinal Obstruction to a Tertiary Care Emergency Department

## TL;DR

A 48-year-old woman died after a rare case of adult intussusception caused by a retained surgical sponge, leading to severe complications.

## Contribution

This case highlights the diagnostic and therapeutic challenges of adult intussusception due to iatrogenic causes.

## Key findings

- Intussusception in adults is rare and often presents with non-specific symptoms, delaying diagnosis.
- A retained surgical mop was identified as the lead point in this case of sigmoid colo-colic intussusception.
- Despite surgical intervention, the patient developed severe complications and died.

## Abstract

Intussusception, typically a pediatric condition, is rare in adults and poses a diagnostic challenge in emergency settings due to its varied presentations. We present a case of a 48-year-old female with a history of recurrent abdominal pain after cholecystectomy (done two years back), who presented with an acute onset of colicky abdominal pain, vomiting, and obstipation. Initial evaluation revealed signs of intestinal obstruction and metabolic acidosis. Imaging confirmed sigmoid colo-colic intussusception with a suspected mass lesion as the lead point, later identified intraoperatively as a retained surgical mop. Despite emergent surgical intervention with bowel resection and stoma formation, the patient’s clinical course was complicated by septic shock, acute kidney injury, and refractory metabolic acidosis, leading to a fatal outcome. Adult intussusception remains a diagnostic and therapeutic challenge, often necessitating prompt surgical intervention, yet the outcome can be poor, especially in cases with significant intra-abdominal pathology and delayed presentation.