Treatment of Small Bowel Hamartoma with Acute Severe Abdominal Pain or Suspected Intussusception

Clinical Scenario

This protocol addresses patients with small bowel hamartoma who present with an episode of acute severe abdominal pain and/or clinical suspicion of small bowel intussusception — a time-critical presentation requiring immediate evaluation and urgent surgical consideration.

Management Overview

When small bowel intussusception cannot be excluded after clinical and diagnostic evaluation, urgent referral to a surgical unit is the immediate action, with emergency surgery indicated even when the diagnosis remains uncertain. The operative approach and the extent of bowel and polyp management are guided by intraoperative findings. The full decision algorithm — including surgical technique selection and step-by-step polyp management — is detailed in the complete protocol…

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References

DOI: 10.3390/jcm10030473

PJS patients with an episode of acute severe abdominal pain and/or suspicion of intussusception should urgently be referred to a surgical unit, preferably a dedicated center. If, after clinical and diagnostic evaluation the event of small bowel intussusception is not ruled out, emergency surgery (even in diagnostic intent) is recommended.

The surgical reduction of intussusception should be undertaken without delay to avoid necrosis and resection of the small bowel. Usually, laparotomy is the safest option, but in selected, milder cases, laparoscopy can be considered. When ischemia is reversible, resection of the bowel should not be done but only a polypectomy.

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