Segmental absence of intestinal musculature (SAIM) of distal ileum in an adult: A case report

Segmental absence of intestinal musculature (SAIM) is a rare entity which is more often observed in the pediatric population and is rarely observed in adults. The definitive diagnosis is based on histopathological evidence of segmental absence of the intestinal musculature. The treatment includes urgent laparotomy with resection of the affected bowel segment. The complications include obstruction and perforation which could increase risk of mortality. Here, we present a case of a 34-year-old male who came with complaints of abdominal pain and wound leak with history of recent previous surgeries. On exploratory laparotomy, a redundant segment of distal ileum and distal to an ileocolonic anastomosis was observed and was excised and sent for histopathological examination. On histology, the distal ileum showed intact mucosa and submucosa and complete absence of muscularis propria.