200 Section - Adult intussusception after a spinal cord injury: a rare case and scoping review of literature.

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

ML

Mark Kit Lim, MBBS

Doctor
MOH Holdings, Singapore, Singapore
Singapore, Singapore

Co-Author(s)

AR

Anna Rosiana, MB ChB, MRCP (UK)

Doctor
Division of Rehabilitation Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.
Singapore, Singapore
PS

Peijing Su, MBBS, MRCP (UK)

Doctor
Division of Rehabilitation Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.
Singapore, Singapore

Case Diagnosis: This case report describes a 60-year-old man with high cervical spinal cord injury who developed a transient small bowel intussusception during his inpatient rehabilitation.

Case Description: The patient, who was initially admitted for central cord syndrome and treated surgically with C3–C6 posterior cervical instrumentation and decompression laminectomy, developed new lower thoracic rib tightness, mild abdominal bloating and abdominal distension but without overt signs of intestinal obstruction. Computed tomography (CT) imaging confirmed a segment of small bowel intussusception without features of ischemia or perforation, and subsequent CT enterography demonstrated spontaneous resolution with no identifiable structural lead point.

Discussions: This case report discusses how autonomic dysregulation following spinal cord injury and commonly used analgesic and spasmolytic medications which impose a high anticholinergic and neuromodulatory burden on the enteric nervous system, may impair intestinal motility, create focal aperistaltic segments, and predispose to adult intussusception. We postulate that the atypical presentation of bilateral lower thoracic rib tightness which improved after resolution of the intussusception could be due to diaphragmatic splinting, referred sensations from cortical reorganization and maladaptive neuroplasticity causing central sensitization, and viscerosomatic convergence causing referred pain and secondary hyperalgesia. This appears to be only the second reported case of adult intussusception associated with spinal cord injury.

Conclusions: This rare case highlights the need for heightened clinical suspicion for adult intussusception in spinal cord injury patients with new abdominal distension or atypical lower thoracic rib tightness and underscores the important role of CT imaging in establishing early diagnosis and implementing timely management.