Ileal–ileal intussusception secondary to multiple small bowel recurrent metastatic melanoma: A case study

Introduction: Intussusception in adults is a rare pathology. Recurrent metastatic melanoma must be considered in patients with a history of cutaneous melanoma. However, cases where there are multiple deposits can present a surgical dilemma for clinicians. Case Report: We present a case of a 52-year-old male with intussusception on a background of cutaneous melanoma in remission over 20 years ago. He received an emergency laparotomy and resection of the pathological lead point and intussuscepted bowel. Two other 5 mm small bowel deposits were left in situ due to distance apart from one another and were undetectable one month later on positron emission tomography (PET) after targeted immunotherapy. Conclusion: This case underscores the importance of prompt surgical exploration in symptomatic adult intussusception, especially in patients with prior melanoma history regardless of length of time of remission. In such patients, pain alone without bowel obstruction may be enough to prompt exploration. Complete oncological resection offers potential survival benefits, although the management of multiple bowel metastases remains challenging. It may be reasonable to leave concurrent small bowel metastases in situ in order to avoid multiple or extensive small bowel resections in specific cases where deposits are miniscule.