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Lobo LMJ, Lopez MPJ, Deogracias JM, Lim MGL. Idiopathic retrograde duodenojejunal intussusception in a patient with multiple congenital anomalies. BMJ Case Rep 2025; 18:e260339. [PMID: 39922571 DOI: 10.1136/bcr-2024-260339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2025] Open
Abstract
This is a case of a woman in her late 20s with multiple musculoskeletal congenital anomalies presenting with a 1 week history of right lower quadrant abdominal pain. She was received dehydrated at the emergency department with a soft, non-tender abdomen. After resuscitation, CT imaging showed evidence of retrograde duodenojejunal intussusception. The patient eventually required a jejunal resection as intervention.
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Affiliation(s)
- Liana Mae Jajurie Lobo
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Marc Paul Jose Lopez
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Jan Miguel Deogracias
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Michael Geoffrey Lee Lim
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
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2
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Johari A, Ahmad S, Selvaraj K, Arunachalam Ganesh R. Ileocolic Intussusception Due to Mucinous Adenocarcinoma in a Middle-Aged Man: A Rare Presentation. Cureus 2025; 17:e78136. [PMID: 40018504 PMCID: PMC11867215 DOI: 10.7759/cureus.78136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2025] [Indexed: 03/01/2025] Open
Abstract
The invagination, or telescoping, of one segment of the colon into another distal segment is the hallmark of the medical disorder known as intussusception. The invaginated portion of the intestines may be propelled forward by peristaltic movements, which may result in bowel blockage, ischemia, and long-term necrosis. The precise cause of intussusception is ambiguous, particularly in cases with no clear lead point. Dysrhythmic contractions and lymphoid hyperplasia are nevertheless linked to the pathophysiology. A 54-year-old male patient arrived at our emergency department after experiencing abdominal pain that had been progressively increasing for the past three days. The patient had a history of previous appendectomy. It was reported that the pain was abrupt and severe and that it grew worse with each meal or drink. During the physical examination, abdominal distension, discomfort, central guarding, and a small palpable mass measuring 3 x 3 cm were identified. Contrast-enhanced CT scans revealed a 7 cm segment intussusception of the terminal ileum into the cecum and ascending colon. Furthermore, the cecum, mesentery, vasculature, and subsequent nodes were all involved in a significant amount of wall edema. During an emergency laparotomy, a terminal ileocolic intussusception was identified. A restricted segmental resection of the terminal ileum was conducted after the adhesiolysis. Subsequently, an end ileostomy was performed. Ileocolic obstructive intussusception is a rare adult condition caused by a mucinous adenocarcinoma. This case provides a unique perspective on the condition. Consequently, physicians must be vigilant for indications of obstructive intussusception in various colon regions that may suggest malignancy.
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Affiliation(s)
- Ananya Johari
- General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND
| | - Samir Ahmad
- General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND
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Kim KH, Kim JS, Lee MS, Han HY, Kim JH. A Case of Colonic Intussusception with Post-polypectomy Electrocoagulation Syndrome and Review of Literature: How to Manage Intussusception Following Colonoscopy? THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2024; 84:132-137. [PMID: 39319435 DOI: 10.4166/kjg.2024.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/10/2024] [Accepted: 09/16/2024] [Indexed: 09/26/2024]
Abstract
Colonic intussusception is often reported to be related to malignancy in adults. Colonoscopy itself with or without polypectomy is known to be a rare cause of colonic intussusception. We encountered a case in which an individual was diagnosed with intussusception following colonoscopy. The patient was a 44-year-old female who, on the same day, had undergone a colonoscopy including endoscopic mucosal resection for a polyp in the ascending colon. She visited the emergency room with complaints of right-sided abdominal pain. Abdominal examination revealed peritoneal irritation in the right upper quadrant. Abdominal CT revealed colocolic intussusception near the hepatic flexure. This was suspected to have been induced by post-polypectomy electrocoagulation syndrome. A laparoscopic right hemicolectomy was performed because conducting a reduction trial through colonoscopy involves a high risk of peritonitis, in addition to a low likelihood of spontaneous reduction of intussusception due to the additional edema and ischemia resulting from the polypectomy. The patient was discharged without complications six days after the surgery. Though some cases have been reported, there is no treatment strategy for intussusception following colonoscopy. Therefore, we report this case of colonic intussusception following colonoscopy, which was found to be caused by Post-polypectomy Electrocoagulation Syndrome, with a literature review.
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Affiliation(s)
- Kyung Hoe Kim
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Joo-Seok Kim
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Moon-Soo Lee
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Hyun-Young Han
- Department of Radiology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Joo Heon Kim
- Department of Pathology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
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4
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Winfield FJ, Nasim S. Adult ileocaecal intussusception caused by lipoma managed in a remote Western Australian hospital. BMJ Case Rep 2024; 17:e259963. [PMID: 39209749 DOI: 10.1136/bcr-2024-259963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Intussusception is rare in adults, making it a challenging and often delayed diagnosis. Patients may re-present with non-specific and subacute abdominal symptoms. Abdominal CT is the most sensitive imaging modality and is often required to make the diagnosis of intussusception. In contrast to the paediatric population, intussusception in adults is most often associated with a pathological lesion acting as a lead point. In adults, the lead point is often secondary to malignancy, though benign lesions can also be implicated. As such, surgical management with selective resection is the mainstay of treatment in adults. We describe a rare case of ileocaecal intussusception in an adult secondary to a large ileocaecal lipoma, successfully treated with laparotomy and resection in a remote Western Australian hospital. The increasing availability of CT imaging and skilled general surgeons in rural and remote Australia allows for the diagnosis and surgical management of such cases without inter-hospital transfer.
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Affiliation(s)
| | - Sana Nasim
- Surgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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5
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Oshima Y, Ishiyama Y, Tanaka H, Fujii T, Okazaki N, Ishii T, Deguchi K, Hirano Y, Koyama I. Single-port laparoscopic surgery for cecum cancer with intussusception: a case report. Surg Case Rep 2024; 10:166. [PMID: 38955928 PMCID: PMC11220058 DOI: 10.1186/s40792-024-01962-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Most adult cases of intussusception are caused by colorectal cancer, and emergency surgery is performed when symptoms such as abdominal pain and vomiting are present. The patient must customarily undergo both bowel decompression and radical surgery for colorectal cancer at the same time, and laparotomy is generally the procedure of choice. CASE PRESENTATION An 86-year-old woman presented to our hospital with diarrhea and bloody stools. Preoperative examination revealed the presence of a cancerous tumor in the advanced part of the transverse colon and bowel intussusception. Radical surgery was successfully performed using the laparoscopic single-port technique through a small incision at the umbilical site to treat intussusception caused by cecum cancer. CONCLUSIONS With only one wound site at the umbilicus, this single-port laparoscopic approach is much less invasive than endoscopic surgery that requires four to five incision wounds to perform the procedure. Furthermore, the patient was discharged without major complications and this surgical technique could be of great benefit if established as a standard procedure in the future.
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Affiliation(s)
- Yuhei Oshima
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan.
| | - Yasuhiro Ishiyama
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
| | - Hiroto Tanaka
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
| | - Tadatsugu Fujii
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
| | - Naoto Okazaki
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
| | - Toshimasa Ishii
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
| | - Katuya Deguchi
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
| | - Yasumitsu Hirano
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
| | - Isamu Koyama
- Department of Gastroenterology, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan
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Hashiguchi K, Mine S, Shiota J, Akashi T, Tabuchi M, Kitayama M, Matsushima K, Akazawa Y, Yamaguchi N, Nakao K. Colonic intussusception after endoscopic mucosal resection successfully managed by endoscopic procedure. Clin J Gastroenterol 2024; 17:466-471. [PMID: 38504057 DOI: 10.1007/s12328-024-01953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/10/2024] [Indexed: 03/21/2024]
Abstract
Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.
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Affiliation(s)
- Keiichi Hashiguchi
- Department of Endoscopy, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan.
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Shoichiro Mine
- Department of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Junya Shiota
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taro Akashi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Maiko Tabuchi
- Department of Histology and Biomedical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Moto Kitayama
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kayoko Matsushima
- Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuko Akazawa
- Department of Histology and Biomedical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoyuki Yamaguchi
- Department of Endoscopy, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Hayashi R, Sawada G, Ichikawa Y, Takata A, Murakami M, Fukunaga H, Kimura H, Morita S. A case of intestinal intussusception with unique hemorrhagic polyps due to AL amyloidosis and excessive anticoagulation. Clin J Gastroenterol 2024; 17:258-262. [PMID: 38270839 DOI: 10.1007/s12328-023-01915-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024]
Abstract
Most adult intussusceptions are secondary to various pathological conditions that serve as a lead point. Because of their serious nature, intussusceptions often require emergency surgery. We report a surgical case of amyloidosis associated with intussusception, probably due to polypoid protrusions and bleeding tendencies. An 80-year-old man with abdominal pain was suspected of having jejunal intussusception on computed tomography. He had been prescribed warfarin for atrial fibrillation, and excessive anticoagulation was observed with a prolonged prothrombin time/international normalized ratio of 5.44 at presentation. After the excessive anticoagulation was resolved, emergency surgery was performed. The intussuscepted jejunum was resected, and a 7 cm long dark-red pedunculated polyp was identified as the lead point, which was accompanied by multiple small pedunculated polyps. Histopathological examination showed that these were all hemorrhagic polyps. Amyloid depositions were observed in the muscularis mucosae, submucosa, and the walls of the blood vessels. Immunohistochemical analysis revealed immunoglobulin light chain amyloidosis. This case is informative to discuss the clinical sequelae of gastrointestinal amyloid deposition.
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Affiliation(s)
- Rie Hayashi
- Department of Surgery, Itami City Hospital, 100 Koyaike, Itami, Hyogo, 664-8540, Japan.
| | - Genta Sawada
- Department of Surgery, Itami City Hospital, 100 Koyaike, Itami, Hyogo, 664-8540, Japan
| | - Yoshitoshi Ichikawa
- Department of Surgery, Itami City Hospital, 100 Koyaike, Itami, Hyogo, 664-8540, Japan
| | - Akihiro Takata
- Department of Surgery, Itami City Hospital, 100 Koyaike, Itami, Hyogo, 664-8540, Japan
| | - Masahiro Murakami
- Department of Surgery, Itami City Hospital, 100 Koyaike, Itami, Hyogo, 664-8540, Japan
| | - Hiroki Fukunaga
- Department of Surgery, Itami City Hospital, 100 Koyaike, Itami, Hyogo, 664-8540, Japan
| | - Hayato Kimura
- Department of Diagnostic Pathology, Itami City Hospital, Itami, Hyogo, Japan
| | - Shunji Morita
- Department of Surgery, Itami City Hospital, 100 Koyaike, Itami, Hyogo, 664-8540, Japan
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8
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Palmer TM, Roman D, Yu WM, Fromm E, Stivers J. Malignant Ileocolocolic Intussusception in a 19-Year-Old Male. Cureus 2024; 16:e58937. [PMID: 38800252 PMCID: PMC11124469 DOI: 10.7759/cureus.58937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Adult intussusception is an infrequent occurrence typically resulting from an identifiable lead point of a benign or malignant etiology. Here, we present a case of a 19-year-old male who presented to the emergency department with complaints of abdominal pain, intractable nausea, and fluctuations between bloody diarrhea and constipation. These symptoms had begun two months prior and had increased in severity, resulting in significant appetite changes. An abdominal and pelvic computed tomography scan without contrast was obtained, which showed evidence of intussusception of the ileocecum into the transverse colon with resultant small bowel obstruction. The patient underwent an exploratory laparotomy, which resulted in a partial ileocolectomy due to the presence of a 6.8 cm cecal mass with palpable mesenteric lymphadenopathy. The pathologic specimen was identified as Burkitt lymphoma based on a combination of histologic, immunohistochemical, and fluorescence in situ hybridization findings. Currently, the patient is undergoing three cycles of rituximab, cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate, ifosfamide, etoposide, and high-dose cytarabine (R-CODOX-M/IVAC) per Magrath protocol for low-risk Burkitt lymphoma.
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Affiliation(s)
| | - Destino Roman
- Internal Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Westin M Yu
- Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Emilie Fromm
- General Surgery, University of Pittsburgh Medical Center, Erie, USA
| | - John Stivers
- General Surgery, University of Pittsburgh Medical Center, Erie, USA
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9
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Skvarce J, Chatterjee A, Velez G, Gurajala R, Schwartz J, Braga-Neto MB. Intussusception in Mosaic Trisomy 14. ACG Case Rep J 2024; 11:e01296. [PMID: 38445258 PMCID: PMC10914228 DOI: 10.14309/crj.0000000000001296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
Mosaic trisomy 14 is exceptionally rare and was first described in the 1970s with fewer than 100 known liveborn individuals. Information about complications and the natural history of the disease is rare, especially in adult patients. This case illustrates an adult patient with severe functional limitations from mosaic trisomy 14 who presented with abdominal pain and failure to thrive and was subsequently found to have intussusception and severe chronic constipation, which was successfully treated conservatively.
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Affiliation(s)
- Jeremy Skvarce
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH
| | - Arjun Chatterjee
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH
| | - Giselle Velez
- Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, OH
| | - Ram Gurajala
- Department of Interventional Radiology, Cleveland Clinic Foundation, Cleveland, OH
| | - Jeffrey Schwartz
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH
| | - Manuel B. Braga-Neto
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH
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10
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Kelly E, Murphy AE, Byrne J, Haidaran A. An extremely rare case of multiple small bowel intussusceptions in a 20-year-old female. J Surg Case Rep 2023; 2023:rjad688. [PMID: 38164215 PMCID: PMC10758242 DOI: 10.1093/jscr/rjad688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024] Open
Abstract
Intussusception, which is characterized by the invagination of one portion of the gastrointestinal tract into an adjacent segment, is an uncommon cause of abdominal pain in adults. Given that it is typically associated with identifiable pathological abnormalities, intussusception can pose a diagnostic challenge in adults due to its rarity and nonspecific symptomatology. This report presents a unique case of multiple small bowel intussusceptions in a 20-year-old female, which emphasizes the importance of clinical suspicion and advanced imaging for an accurate diagnosis.
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Affiliation(s)
- Elaine Kelly
- Department of Emergency General Surgery, Cork University Hospital, Wilton, Cork T12 DC4A, Ireland
| | - Amy E Murphy
- Department of Emergency General Surgery, Cork University Hospital, Wilton, Cork T12 DC4A, Ireland
| | - James Byrne
- Department of Emergency General Surgery, Cork University Hospital, Wilton, Cork T12 DC4A, Ireland
| | - Ahmed Haidaran
- Department of Emergency General Surgery, Cork University Hospital, Wilton, Cork T12 DC4A, Ireland
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11
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Elkhawaga M, Ross B, Sugo E, Reedman-Hawes C, Balasuriya H. Ileocaecal Intussusception Due to Burkitt Lymphoma: A Surgical and Haematological Emergency. Cureus 2023; 15:e50904. [PMID: 38249231 PMCID: PMC10799675 DOI: 10.7759/cureus.50904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Intussusception is the protrusion and invagination of a segment of the bowel, referred to as the intussusceptum, into another adjacent segment known as the intussuscipiens. The age range during which intussusception is most observed in children is between three and 18 months. Unlike intussusceptions in children, where the cause is often idiopathic, a specific underlying factor is discernible in a significant majority of cases among adults. In this article, we will present a case of intussusception in an adolescent caused by Burkitt lymphoma.
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Affiliation(s)
| | - Bryony Ross
- The Children's Cancer and Haematology Service, John Hunter Children's Hospital, Newcastle, AUS
| | - Ella Sugo
- Anatomical Pathology, John Hunter Hospital, Newcastle, AUS
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12
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Lee IC, Tsai HL, Huang CW, Wang JY. Jejunojujunal intussusception as a rare complication of feeding jejunostomy. FORMOSAN JOURNAL OF SURGERY 2023; 56:204-206. [DOI: 10.1097/fs9.0000000000000062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2025] Open
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13
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Álvarez-Bautista FE, Moctezuma-Velázquez P, Pimienta-Ibarra AS, Vergara-Fernández O, Salgado-Nesme N. Adult intussusception: still a challenging diagnosis for the surgeon. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2023; 88:315-321. [PMID: 35810092 DOI: 10.1016/j.rgmxen.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/23/2021] [Indexed: 10/17/2022]
Abstract
INTRODUCTION AND AIM Intussusception is rare in adults and can occur in the small bowel and colon. Its atypical presentation makes the diagnosis difficult. The aim of the present study was to evaluate the causes, clinical characteristics, and treatment outcomes of adult intussusception and to determine whether there was an association between etiology and clinical presentation. MATERIALS AND METHODS A retrospective study was carried out on patients above 18 years of age that were treated for intussusception at a tertiary care hospital, between 2000 and 2020. The findings were summarized utilizing descriptive and inferential statistics. RESULTS Twenty-eight cases were identified. Median patient age was 46 years (18-80) and median symptom duration was 18 days. Abdominal pain was the most frequent symptom (96.42%). The intussusceptions registered were enteroenteric (14), ileocecal (4), ileocolonic (4), colocolonic (5), and colorrectal (1). Intussusception etiology was benign in 15 cases, 9 were associated with malignancy, and 4 were idiopathic. Surgery was performed on 11 patients with enteroenteric intussusception and on all the cases of ileocecal, ileocolonic, colocolonic, and colorectal intussusception. There were 2 events of perioperative mortality (8%) and 8 of postoperative morbidity (32%). No significant differences were found regarding symptom duration or length of hospital stay, when the etiologic groups were compared. CONCLUSIONS Intussusception is rare in adults. Diagnosis is a challenge because of the nonspecific signs and symptoms. Surgical resection should be considered in the definitive treatment and management should be individualized according to the patient's comorbidities, clinical presentation, and risk of malignancy.
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Affiliation(s)
- F E Álvarez-Bautista
- Departamento de Cirugía Colorrectal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - P Moctezuma-Velázquez
- Departamento de Cirugía Colorrectal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - A S Pimienta-Ibarra
- Departamento de Cirugía General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - O Vergara-Fernández
- Departamento de Cirugía Colorrectal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - N Salgado-Nesme
- Departamento de Cirugía General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico.
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14
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Zabeirou A, Efared B, James Didier L, Younssa H, Adama S, Moussa Y, Rachid S. Appendiceal mucocele as an exceptional cause of ileocecocolic intussusception in adults: a case report. J Med Case Rep 2023; 17:392. [PMID: 37710264 PMCID: PMC10503163 DOI: 10.1186/s13256-023-04133-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Intussusception is a rare condition in adults, accounting for 5% of intestinal intussusception and being responsible for approximately 1% of all adult bowel obstructions. Neoplastic origin is the most common etiology of intestinal intussusception in adults, unlike pediatric intussusception, which is usually idiopathic. Intussusception due to the appendiceal mucocele is exceptional, and only a few cases have been reported in the medical literature. CASE PRESENTATION We report the case of a 25-year-old black African male patient with no medical history. He presented to the emergency department for abdominal pain, nausea, and bilious vomiting. The abdominal examination revealed typical signs of acute bowel obstruction. Enhanced abdominopelvic computed tomography showed an invagination of the last ileal loop, cecum, and ascending colon into the lumen of the transverse colon, with a rounded image with hypodense content and some calcifications compatible with an appendiceal mucocele. An emergency exploratory laparoscopy was performed and confirmed the ileocecocolic intussusception. Right hemicolectomy and ileocolic anastomosis were performed. The patient recovery postoperatively was uneventful, and he was discharged 4 days later. Histological examination of the surgical specimen confirmed the diagnosis of mucinous cystadenoma. CONCLUSION The symptoms of bowel intussusception with the appendiceal mucocele as the lead point in adults are similar to any other bowel intussusception. Differential diagnosis is often carried out thanks to the injected abdominal computed tomography scan.
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Affiliation(s)
- Aliou Zabeirou
- Department of General and Visceral Surgery, Hôpital Général de Référence, Niamey, Niger.
| | - Boubacar Efared
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Lassey James Didier
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Hama Younssa
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Saidou Adama
- Department of General and Visceral Surgery, Hôpital Général de Référence, Niamey, Niger
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Younoussa Moussa
- Department of General and Visceral Surgery, Hôpital Général de Référence, Niamey, Niger
| | - Sani Rachid
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
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15
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Fiordaliso M, De Marco FA, Costantini R, Panaccio P, Chiesa PL. Adenocarcinoma of the sigmoid colon causing sigmoido-rectal intussusception: A rare entity in adults. Int J Surg Case Rep 2023; 107:108331. [PMID: 37210804 DOI: 10.1016/j.ijscr.2023.108331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/23/2023] Open
Abstract
INTRODUCTION Intussusception occurs when a more proximal portion of the bowel (intussusceptum) invaginates into the more distal bowel (intussuscipiens). The pathomechanism is thought to involve altered bowel peristalsis at the intraluminal lesion, which is then a lead point for the intussusceptum. Intestinal intussusception is rare in adults, accounting for approximately 1 % of all bowel obstructions. We report a unique case in which a partially obstructing sigmoid cancer caused full thickness rectal prolapse requiring surgical intervention. PRESENTATION OF CASE A 75-year-old male presented in the emergency department due to anal haemorrhage for 5 days. On clinical examination his abdomen was distended with signs of peritoneal irritation in the right quadrants. The CT scan showed sigmoid-rectal intussusception with an sigmoid colonic tumour. The patient underwent emergency anterior resection of the rectum without reduction of the intussusception. Histological examination revealed a sigmoid adenocarcinoma. DISCUSSION Intussusception is the most common urgent situation among the pediatric population but its incidence in adults is very rare. The diagnosis is difficult to establish with history and physical exam findings alone. Since in adults, unlike children, in most cases a malignant pathology acts as a lead point, the treatment of this pathology still reserves doubts. Recognizing and understanding pertinent signs, symptoms, and imaging findings is essential to the early diagnosis and appropriate management of adult intussusception. CONCLUSION The appropriate management of adult intussusception is not always clear cut. There is controversy about the reduction before resection in cases of sigmoidorectal intussusception.
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Affiliation(s)
| | | | - Raffaele Costantini
- Institute of Surgical Pathology, Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
| | - Paolo Panaccio
- General Surgery Unit, Renzetti Hospital, Lanciano, Italy
| | - Pierluigi Lelli Chiesa
- Pediatric Surgery Unit, Hospital "Santo Spirito" of Pescara and University "G. d'Annunzio" of Chieti Pescara, Pescara, Italy
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16
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Hashem A, Ismayl A, Mahmoud AA, Khalouf A, Mohammed MR. Atypical Peutz-Jeghers Syndrome Presenting With a Huge Jejunojejunal Intussusception in a Young Male: A Case Report. Cureus 2023; 15:e36107. [PMID: 37065405 PMCID: PMC10098220 DOI: 10.7759/cureus.36107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/16/2023] Open
Abstract
Intussusception is considered one of the rare causes of intestinal obstruction in adults compared to pediatric patients. It usually presents with non-specific clinical manifestations ranging from mild recurrent abdominal pain to severe acute abdominal pain. The non-specificity of its symptoms makes it difficult to diagnose preoperatively. As 90% of adult intussusceptions are due to a pathological lead point, this prompts the underlying medical condition to be identified. We herein report a rare case of a 21-year-old male with atypical clinical features of Peutz-Jegher syndrome (PJS), presenting with jejunojejunal intussusception as a result of a hamartomatous intestinal polyp. A preliminary diagnosis of intussusception was made after an abdominal computed tomography (CT) scan and was confirmed intraoperatively. Postoperatively, the patient's condition improved steadily, and he was discharged with a referral to the gastroenterologist for further assessment.
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17
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Chu A, McDonald C, Lau SYC, Stupart DA. Recto-sigmoid intussusception in a 90-year-old lady presenting with colonic obstruction. ANZ J Surg 2023; 93:359-360. [PMID: 35532149 DOI: 10.1111/ans.17760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Alex Chu
- Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Conor McDonald
- Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Steve Yee Chiang Lau
- Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.,School of Medicine, Faculty of Health, Deakin University, Victoria, Geelong, Australia
| | - Douglas A Stupart
- Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.,School of Medicine, Faculty of Health, Deakin University, Victoria, Geelong, Australia
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18
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Choong ZS, Aksakal G, Flanagan J, Chan AJ, Smith Q, Stuchbery J. Ileo-ileal intussusception: a rare manifestation of metastatic synovial sarcoma. ANZ J Surg 2023; 93:389-390. [PMID: 35668554 DOI: 10.1111/ans.17825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/17/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Zhi Shyuan Choong
- General Surgery, Albury Wodonga Health, University of New South Wales, Albury, New South Wales, Australia
| | - Gamze Aksakal
- General Surgery, Albury Wodonga Health, Albury, New South Wales, Australia
| | - Jean Flanagan
- General Surgery, Albury Wodonga Health, Albury, New South Wales, Australia
| | - Amy Jennifer Chan
- Radiology, Albury Wodonga Health, Albury, New South Wales, Australia
| | - Quinton Smith
- General Surgery, Albury Wodonga Health, Albury, New South Wales, Australia
| | - John Stuchbery
- General Surgery, Albury Wodonga Health, Albury, New South Wales, Australia
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19
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Deshmukh S, Pol V, Bhosale A, Pol J, Dugad V. Intestinal lipoma causing intussusception in an adult – A case report. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2023. [DOI: 10.4103/mjdrdypu.mjdrdypu_929_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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20
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Hejazi P, Yousefi S, Hemmati H, Faraji N, Mohammadyari F. Intussusception of the bowel in a young woman: A case report. Clin Case Rep 2022; 10:e6309. [PMID: 36177073 PMCID: PMC9478627 DOI: 10.1002/ccr3.6309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/11/2022] [Accepted: 08/25/2022] [Indexed: 12/05/2022] Open
Abstract
Intussusception is a condition in which a segment of the gastrointestinal tract invaginates into the lumen of another segment. Adult intussusception is less common than juvenile intussusception in terms of cause, appearance, and treatment. Because the clinical picture can be quite atypical and difficult to interpret, it is frequently misdiagnosed at first. Herein, we report the case of a previously healthy 23-year-old female patient who presented to the Emergency Department (ED) with acute abdominal pain, vomiting, and diarrhea for 1 day following her last menstrual period. Ileocecal intussusception was discovered throughout the investigation. She was rushed for open abdominal surgery. Meckel's diverticulum was found as a pathologic lead point in the resected specimen, with no evidence of malignancy. Although intussusception is rare in adults, it should be considered in patients who have nonspecific stomach pain.
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Affiliation(s)
- Peyman Hejazi
- Razi Clinical Research Development Unit, Razi HospitalGuilan University of MedicalRashtIran
| | - Saeed Yousefi
- Department of General Surgery, School of Medicine Road Trauma Research Center, Razi HospitalGuilan University of Medical SciencesRashtIran
| | - Hossein Hemmati
- Razi Clinical Research Development Unit, Razi HospitalGuilan University of MedicalRashtIran
- Department of General Surgery, School of Medicine Road Trauma Research Center, Razi HospitalGuilan University of Medical SciencesRashtIran
| | - Niloofar Faraji
- Razi Clinical Research Development Unit, Razi HospitalGuilan University of MedicalRashtIran
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21
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Wang TL, Gong XS, Wang J, Long CY. Intestinal intussusception caused by intestinal duplication and ectopic pancreas: A case report and review of literature. World J Clin Cases 2022; 10:2261-2267. [PMID: 35321161 PMCID: PMC8895165 DOI: 10.12998/wjcc.v10.i7.2261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/17/2021] [Accepted: 01/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intestinal intussusception caused by intestinal duplication and ectopic pancreas is extremely rare in the clinic and has not been reported previously.
CASE SUMMARY A 29-year-old man was admitted to the hospital for chronic abdominal pain and bloating. The preoperative diagnosis was intestinal obstruction and intussusception. Then, laparotomy, partial small intestinal resection and extraintestinal decompression were performed. Postoperative pathology confirmed intestinal duplication and ectopic pancreas. After surgery, the patient recovered well with no complications. No recurrence was observed after more than 5 mo of follow-up.
CONCLUSION We report a new case of a young male with intussusception caused by intestinal duplication and ectopic pancreas. Surgery is the main treatment for these conditions. This study aimed to raise awareness and provide information to improve the clinical management of this rare yet serious condition.
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Affiliation(s)
- Tao-Li Wang
- Department of Pathology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
| | - Xiao-Song Gong
- The Second Department of General Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
| | - Jin Wang
- The Second Department of General Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
| | - Chen-Yan Long
- The Second Department of General Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
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22
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Luciano E, Marar O, Cocco M. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac184. [PMID: 35665398 PMCID: PMC9154063 DOI: 10.1093/jscr/rjac184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/06/2022] [Indexed: 11/12/2022] Open
Abstract
The incidence of complications after colonoscopy is low and has been reported to range of 0.01–0.9%. Of these complications, colocolonic intussusception after colonoscopy is exceedingly rare, with around 12 known cases described in the literature. This case report details the presentation and operative management of a patient who developed an ischemic stoma due to a colocolonic intussusception of an end colostomy after a colonoscopy. Intraoperative surgical exploration revealed a colocolonic intussusception involving the end colostomy. This is the first known documented occurrence of this phenomenon.
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Affiliation(s)
| | - Omar Marar
- Department of Surgery, Central Michigan University College of Medicine, Saginaw, MI, USA
| | - Maxwell Cocco
- Department of Surgery, Central Michigan University College of Medicine, Saginaw, MI, USA
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23
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Moniakis AA, Flamourakis ME, Gkionis IG, Giakoumakis MI, Tsagkataki ES, Kazamias GM, Spiridakis KG, Christodoulakis MS. Ileocolic Intussusception in a Woman: A Case Report and Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e933341. [PMID: 34623978 PMCID: PMC8515498 DOI: 10.12659/ajcr.933341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Intussusception is a rare pathological entity in adults and remains a diagnostic challenge for clinicians, as it shares many clinical signs and symptoms with other morbid conditions (including appendicitis, abdominal hernias, colic, volvulus, and Meckel diverticulum). High clinical suspicion and use of appropriate imaging techniques are essential for early diagnosis and treatment of intussusception. Surgical intervention is the treatment of choice in cases of sustained and persistent invagination. CASE REPORT We present the case of a 65-year-old woman with a medical history of Crohn's disease, diabetes mellitus type II, hypertension, and rheumatoid arthritis. She was hospitalized for diarrhea, fatigue, and anemia. Computerized tomography of the abdomen and a colonoscopy revealed telescoping of the ileum, ileocecal valve, and part of the ascending colon inside the terminal segment of the ascending colon. The antegrade ileocolic intussusception was treated by performing a right hemicolectomy. The pathologic examination of the excised intestine showed mucosal lesions compatible with Crohn's disease, an inflammatory fibroid polyp at the terminal section of the ileum, and a low-grade appendiceal mucinous neoplasm. CONCLUSIONS Regardless of the etiology, when the normal motility of the intestine is altered, it can lead to invagination. Although intussusception is rare, it must always be part of the differential diagnosis for a patient presenting with constant abdominal pain.
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Affiliation(s)
- Alexandros A Moniakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Mathaios E Flamourakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Ioannis G Gkionis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Michail I Giakoumakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Eleni S Tsagkataki
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Georgios M Kazamias
- Department of Pathology, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
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24
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Zanni M, Vaccari S, Lauro A, Marino IR, Cervellera M, D'Andrea V, Tonini V. Bleeding Edge Therapy: Ileocolic Intussusception Due to Ileocecal Valve Adenocarcinoma and Its Management in an Adult Patient-Case Report and Literature Review. Dig Dis Sci 2021; 66:1436-1440. [PMID: 33511490 DOI: 10.1007/s10620-021-06849-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 02/08/2023]
Abstract
Adenocarcinoma as the primary cause of bowel intussusception is uncommon. We describe the case of a 86-year-old patient admitted for ileocecal intussusception due to the presence of adenocarcinoma, located in the ileocecal valve and right colon. The etiologies of intussusception, its diagnosis, and conservative or surgical treatments are discussed, with attention placed on the indications for reduction of the invagination prior to surgical resection.
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Affiliation(s)
- M Zanni
- Emergency Surgery Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, Bologna, Italy
| | - S Vaccari
- Department of Surgical Sciences, La Sapienza University Hospital, Rome, Italy
| | - A Lauro
- Emergency Surgery Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, Bologna, Italy.
| | - I R Marino
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - M Cervellera
- Emergency Surgery Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, Bologna, Italy
| | - V D'Andrea
- Department of Surgical Sciences, La Sapienza University Hospital, Rome, Italy
| | - V Tonini
- Emergency Surgery Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, Bologna, Italy
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25
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Kansoun A, Mohtar IA, Bahmad M, Houcheimi F, Maanieh N, Hazim M, Rahal K, Amiry AR, Hoteit A, Saeed AA, Fakhruddin N, Wehbe M. Colo-colic intussusception secondary to colon lipoma: A case report. Int J Surg Case Rep 2021; 81:105695. [PMID: 33721822 PMCID: PMC7970352 DOI: 10.1016/j.ijscr.2021.105695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/14/2021] [Accepted: 02/14/2021] [Indexed: 11/25/2022] Open
Abstract
Intestinal intussusception is rare in adults and it is associated with lead points. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Colo-colic intussusception caused by lipoma must be considered in the differential when diagnosing adults with right lower quadrant pain. Introduction and importance Intestinal intussusception is rare in adults and it is associated with lead points affecting the colon in around 17% of patients. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Indeed, the incidence of intestinal intussusception is much rare when caused by lipomas. Case presentation Our patient is a 29-year-old male, previously healthy and admitted for severe right lower quadrant abdominal pain of 2-day duration. Computed tomography (CT) scan of the abdomen and pelvis showed large mass of fat consistency containing colon structure. Clinical Discussion Urgent laparotomy was opted during which colo-colic intussusception was diagnosed and right hemicolectomy with primary ileocolic anastomosis was performed. Pathology report showed that intussusception was induced by a colon lipoma. Patient had an uneventful hospital stay and was discharged on post-operative day 5. Conclusion Thus we recommend that colo-colic intussusception caused by lipoma be considered in the differential when diagnosing adults with right lower quadrant pain.
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Affiliation(s)
- Alaa Kansoun
- Lebanese University, Faculty of Medical Sciences, Department of General Surgery, Beirut, Lebanon.
| | - Iyad Al Mohtar
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | - Marwan Bahmad
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | | | - Nisreen Maanieh
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | - Mouhamad Hazim
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | - Khaled Rahal
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | | | - Ali Hoteit
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | | | - Najla Fakhruddin
- Department of Pathology, Hammoud Hospital University Medical Center, Saida, Lebanon.
| | - Mohammad Wehbe
- Department of General Surgery, Hammoud Hospital University Medical Center, Saida, Lebanon.
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26
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Sharma A, Thakur A. Ileocolic intussusception due to intestinal lipoma in an adult patient. Clin Case Rep 2021; 9:1524-1528. [PMID: 33768881 PMCID: PMC7981757 DOI: 10.1002/ccr3.3825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 01/01/2023] Open
Abstract
Intestinal obstruction due to intussusception caused by intestinal lipomas is a rare condition in adults that needs urgent treatment. CT (Computerised Tomography) is the radiologic modality of choice for diagnosis. Surgery is the treatment of choice and has excellent outcome.
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27
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Sugimoto K, Uejima S, Uchiyama Y, Yasue R, Nambu K, Ishikawa J, Koma Y, Akita T, Toh T, Fujimoto T. Metachronous primary cancer of the tongue and malignant lymphoma of the small intestine: A case report. Medicine (Baltimore) 2021; 100:e24806. [PMID: 33607843 PMCID: PMC7899883 DOI: 10.1097/md.0000000000024806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Oral cancer often causes secondary primary cancers in the upper gastrointestinal tract. However, there are no reports of secondary primary cancers in patients with oral squamous cell carcinoma and malignant lymphoma of the small intestine. This report describes a case of metachronous multiple primary cancers of the tongue and small intestine malignant lymphoma. PATIENTS CONCERNS The patient was admitted to our department with the chief complaint of pain in the right tongue. Partial tongue resection and supraomohyoid neck dissection were performed. One year after surgery, the patient experienced abdominal pain and bloody stools. DIAGNOSIS Diffuse large B-cell lymphoma (DLBCL) was diagnosed via histological examination. INTERVENTIONS A terminal ileum resection was performed. Postoperatively, the patient received 6 courses of rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP). OUTCOMES Five years after his initial diagnosis, there is no evidence of recurrence, metastasis, or other primary cancer. LESSONS Oral cancer patients should always be followed up owing to a possibility of malignant tumors in other areas.
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Affiliation(s)
- Keisuke Sugimoto
- Department of Oral and Maxillofacial Surgery, Iwata City Hospital, Iwata
| | - Shinji Uejima
- Department of Oral and Maxillofacial Surgery, Nagoya University Hospital
| | - Yumiko Uchiyama
- Department of Oral and Maxillofacial Surgery, Iwata City Hospital, Iwata
| | - Reita Yasue
- Department of Oral and Maxillofacial Surgery, Iwata City Hospital, Iwata
| | - Kazuya Nambu
- Department of Oral and Maxillofacial Surgery, Iwata City Hospital, Iwata
| | - Jun Ishikawa
- Department of Oral and Maxillofacial Surgery, Iwata City Hospital, Iwata
| | - Yoshiro Koma
- Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya
| | - Takako Akita
- Department of Oral and Maxillofacial Surgery, Tokoname City Hospital, 3-3-3 Asukadai, Tokoname, Aichi, Japan
| | - Taketomo Toh
- Department of Oral and Maxillofacial Surgery, Tokoname City Hospital, 3-3-3 Asukadai, Tokoname, Aichi, Japan
| | - Takehiro Fujimoto
- Department of Oral and Maxillofacial Surgery, Iwata City Hospital, Iwata
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28
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Hsieh YL, Hsu WH, Lee CC, Wu CC, Wu DC, Wu JY. Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor: A case report and review of the literature. World J Clin Cases 2021; 9:838-846. [PMID: 33585630 PMCID: PMC7852652 DOI: 10.12998/wjcc.v9.i4.838] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/19/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastric gastrointestinal stromal tumor (GIST) is the most common etiology of gastroduodenal intussusception. Although gastroduodenal intussusception caused by gastric GIST is mostly treated by surgical resection, the first case of gastroduodenal intussusception caused by gastric GIST was treated by endoscopic submucosal dissection (ESD) in Japan in 2017.
CASE SUMMARY An 84-year-old woman presented with symptoms of postprandial fullness with nausea and occasional vomiting for a month. Initially, she visited a local clinic for help, where abdominal sonography revealed a space-occupying lesion around the liver, so she was referred to our hospital for further confirmation. Abdominal sonography was repeated, which revealed a mass with an alternating concentric echogenic lesion. Esophagogastroduodenoscopy (EGD) was performed under the initial impression of gastric cancer with central necrosis and showed a tortuous distortion of gastric folds down from the lesser curvature side to the duodenal bulb with stenosis of the gastric outlet. EGD was barely passed through to the 2nd portion of the duodenum and a friable ulcerated mass was found. Several differential diagnoses were suspected, including gastroduodenal intussusception, gastric cancer invasion to the duodenum, or pancreatic cancer with adherence to the gastric antrum and duodenum. Abdominal computed tomography for further evaluation was arranged and showed gastroduodenal intussusception with a long stalk polypoid mass 5.9 cm in the duodenal bulb. Under the impression of gastroduodenal intussusception, ESD was performed at the base of the gastroduodenal intussusception; unfortunately, a gastric perforation was found after complete resection was accomplished, so gastrorrhaphy was performed for the perforation and retrieval of the huge polypoid lesion. The gastric tumor was pathologically proved to be a GIST. After the operation, there was no digestive disturbance and the patient was discharged uneventfully on the 10th day following the operation.
CONCLUSION We present the second case of gastroduodenal intussusception caused by GIST treated by ESD. It is also the first case report of gastroduodenal intussusception by GIST in Taiwan, and endoscopic reduction or resection is an alternative treatment for elderly patients who are not candidates for surgery.
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Affiliation(s)
- Yi-Lun Hsieh
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Wen-Hung Hsu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Ching-Chun Lee
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Chun-Chieh Wu
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Deng-Chyang Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Jeng-Yih Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
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29
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Vagholkar K. Pedunculated Lipoma of the Caecum Causing Colocolic Intussusception in an Adult. MEDICAL ARCHIVES (SARAJEVO, BOSNIA AND HERZEGOVINA) 2021. [PMID: 33424098 DOI: 10.5455/medarh.2020.74.393-395.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Introduction Colocolic intussusception in adults is uncommon and poses both a diagnostic and therapeutic dilemma. The association of an underlying malignancy necessitates a preoperative confirmation of diagnosis. The presenting features are variable. Hence contrast enhanced computed tomography of the abdomen is pivotal for diagnosis. An en bloc resection of the specimen in accordance with standard oncological principles is the mainstay of treatment. Case report A case of colocolic intussusception in an adult is presented to highlight the difficulties in preoperative diagnosis and in selecting the best surgical option for treatment. Conclusion Adult bowel intussusception is a diagnostic dilemma with preoperative diagnosis being the biggest challenge. CT scan of the abdomen is an excellent diagnostic modality with high diagnostic accuracy. Explorative laparotomy with en bloc resection is mainstay of treatment in adults.
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Affiliation(s)
- Ketan Vagholkar
- Department of Surgery, D.Y.Patil University School of Medicine. Navi Mumbai, India
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Kim Y, Jung YY, Kim EK. Leiomyosarcoma of the Sigmoid Colon Causing Sigmoido-Rectal Intussusception: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:201-206. [PMID: 36237468 PMCID: PMC9432394 DOI: 10.3348/jksr.2020.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/16/2020] [Accepted: 05/22/2020] [Indexed: 11/15/2022]
Abstract
The most common malignant tumors in the colon are adenocarcinomas, while leiomyosarcoma (LMS) are rare. Here, we report a case of LMS of the sigmoid colon in a 73-year-old man who presented with sigmoido-rectal intussusception, which was discovered by abdominal computed tomography. As LMS of the colon is uncommon and is rarely associated with intussusception, we have described the imaging features in this case report.
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Affiliation(s)
- Yongsang Kim
- Department of Radiology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Yoon Young Jung
- Department of Radiology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Eun Kyung Kim
- Department of Pathology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
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Yamauchi N, Ito T, Matsuoka H, Chohno T, Hasegawa H, Kakeji Y, Ohnishi T. Intussusception caused by a small intestinal lipoma with ectopic gastric mucosa containing gastric cystica profunda component cells within the inverted Meckel's diverticulum: a case report. Surg Case Rep 2020; 6:286. [PMID: 33184680 PMCID: PMC7661620 DOI: 10.1186/s40792-020-01061-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022] Open
Abstract
Background Lipomas are the most common cause of intussusception in adults. To our knowledge, however, no cases of lipoma and ectopic gastric mucosa with gastritis cystica profunda (GCP) have been reported. We report a case of intussusception caused by a small intestinal lipoma with ectopic gastric mucosa containing GCP-component cells within the inverted Meckel’s diverticulum. Case presentation A female in her 40s underwent computed tomography for postoperative follow-up of left breast cancer. A tumor, suspected to be a lipoma, was found in the ileum. Since there were no symptoms, the patient underwent regular follow-up. However, gradual enlargement was observed, and surgery was recommended due to the risk of intussusception. After reduction via the Hutchinson technique, laparoscopically assisted partial resection of the small intestine was performed due to suspicion that the tumor was causing intussusception starting from the ileum. Histopathologic examinations revealed proliferation of mature adipose tissue in the subserosal layer, which was diagnosed as lipoma. Furthermore, adipose tissue was found in the stem area and accordingly, we diagnosed lipoma associated with the inverted Meckel’s diverticulum. Moreover, gastric mucosa-like crypt epithelium and proper glandular tissue were identified in the mucosal membrane at the area of onset, and signs of gastric pit dilatation over the submucosa and crypt epithelium hyperplasia were observed. Diagnosis was ectopic gastric mucosa containing GCP component tissue. Conclusions Intussusception in the small intestine complicated with lipoma and ectopic gastric mucosa with GCP within the Meckel’s diverticulum has not been reported, demonstrating the rarity of our case.
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Affiliation(s)
- Natsuko Yamauchi
- Department of Surgery, Nishiwaki Municipal Hospital, 652-1 Shimotoda, Nishiwaki, Hyogo, 677-0043, Japan.,Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Takashi Ito
- Department of Surgery, Nishiwaki Municipal Hospital, 652-1 Shimotoda, Nishiwaki, Hyogo, 677-0043, Japan
| | - Hiroki Matsuoka
- Department of Surgery, Nishiwaki Municipal Hospital, 652-1 Shimotoda, Nishiwaki, Hyogo, 677-0043, Japan
| | - Teruhiro Chohno
- Department of Surgery, Nishiwaki Municipal Hospital, 652-1 Shimotoda, Nishiwaki, Hyogo, 677-0043, Japan
| | - Hiroshi Hasegawa
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Takamasa Ohnishi
- Department of Diagnostic Pathology, Nishiwaki Municipal Hospital, 652-1 Shimotoda, Nishiwaki, Hyogo, 677-0043, Japan.
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Vagholkar K. Pedunculated Lipoma of the Caecum Causing Colocolic Intussusception in an Adult. Med Arch 2020; 74:393-395. [PMID: 33424098 PMCID: PMC7780799 DOI: 10.5455/medarh.2020.74.393-395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/23/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Colocolic intussusception in adults is uncommon and poses both a diagnostic and therapeutic dilemma. The association of an underlying malignancy necessitates a preoperative confirmation of diagnosis. The presenting features are variable. Hence contrast enhanced computed tomography of the abdomen is pivotal for diagnosis. An en bloc resection of the specimen in accordance with standard oncological principles is the mainstay of treatment. CASE REPORT A case of colocolic intussusception in an adult is presented to highlight the difficulties in preoperative diagnosis and in selecting the best surgical option for treatment. CONCLUSION Adult bowel intussusception is a diagnostic dilemma with preoperative diagnosis being the biggest challenge. CT scan of the abdomen is an excellent diagnostic modality with high diagnostic accuracy. Explorative laparotomy with en bloc resection is mainstay of treatment in adults.
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Affiliation(s)
- Ketan Vagholkar
- Department of Surgery, D.Y.Patil University School of Medicine. Navi Mumbai, India
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Laparoscopic Treatment of Colonic Intussusception Caused by Sigmoid Colon Cancer. THE JOURNAL OF MINIMALLY INVASIVE SURGERY 2020; 23:149-151. [PMID: 35602380 PMCID: PMC8985619 DOI: 10.7602/jmis.2020.23.3.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 11/08/2022]
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Di Buono G, Randisi B, Romano G, Ricupati F, Buscemi S, Agrusa A. Recurrent intussusception of small bowel in a young patient due to metastases from cardiac undifferentiated pleomorphic sarcoma: A first ever case report. Int J Surg Case Rep 2020; 77S:S13-S16. [PMID: 32972888 PMCID: PMC7876920 DOI: 10.1016/j.ijscr.2020.09.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Undifferentiated metastatic pleomorphic sarcoma (Malignant Fibrous Histiocytoma) is a rare entity in the small intestine, especially when the primary tumor is of cardiac origin. CASE REPORT We report a case of metastatic intestinal undifferentiated pleomorphic sarcoma in a young patient with a history of primary cardiac tumor in the left atrium and recurrent small bowel intussusception. He was admitted for abdominal pain and constipation. A segmental resection of the small intestine was performed with side-to-side entero-enteroic anastomosis. DISCUSSION Intussusception of the small bowel is rare in adults and it represents about 1-3% of intestinal obstructions. It mainly affects the fifth decade with a male/female ratio of 1:5 More than 60% of patients with intussusception have a tumor with 50% being malignant. This type of intussusception can be diagnosed on the CT abdominalscan. Radiological features include a typical "target" sign with overdistention of the proximal intestine and air-fluid levels, but the diagnosis of certainty is made by exploratory laparotomy. CONCLUSION The metastatic tumors that cause intussusception represent a rare clinical condition in adult patients, but much more common than primary ones. Metastasis to the small intestine are part of differential diagnosis in patient with a history of tumor who present with intussusception.
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Affiliation(s)
- Giuseppe Di Buono
- Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, Italy.
| | - Brenda Randisi
- Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, Italy.
| | - Giorgio Romano
- Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, Italy.
| | - Federica Ricupati
- Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, Italy.
| | - Salvatore Buscemi
- Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, Italy.
| | - Antonino Agrusa
- Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, Italy.
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Agrawal S, Khanal B, Gurung R, Sah SP, Gupta RK. Appendiculo-cecal intussusception: a case report and literature review. J Surg Case Rep 2020; 2020:rjaa246. [PMID: 32855799 PMCID: PMC7444313 DOI: 10.1093/jscr/rjaa246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/09/2020] [Accepted: 06/20/2020] [Indexed: 11/24/2022] Open
Abstract
Intussusception of the appendix is a rare disease that constitutes a diagnostic challenge to the surgeon. Intussusception is defined as the telescoping of a segment of the gastrointestinal tract into an adjacent one. We are reporting a case of a 14-year-old boy who presented in our institution with the features of acute appendicitis. On exploration appendiculo-cecal intussusception was found for which right hemicolectomy with ileotransverse colon anastomosis was done.
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Affiliation(s)
- Sunit Agrawal
- Department of General & Minimal Access Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Bhawani Khanal
- Department of General & Minimal Access Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Roshan Gurung
- Department of General & Minimal Access Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Suresh Prasad Sah
- Department of General & Minimal Access Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Rakesh Kumar Gupta
- Department of General & Minimal Access Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Abdulla HA, Taei THA, Alsayed B, Alawadhi K. Ileo-caecal intussusception secondary to lipoma in an adult: A rare cause for intestinal obstruction. Radiol Case Rep 2020; 15:1693-1696. [PMID: 32742530 PMCID: PMC7387731 DOI: 10.1016/j.radcr.2020.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/21/2022] Open
Abstract
Intussusception in adults is a rare condition. Unlike in children, it is often associated with a pathologic lesion that serves as a lead point. We report an unusual case of ileo-caecal intussusception due to lipoma. A 51-year-old male presented with symptoms and signs of intestinal obstruction. CT scan revealed bowel obstruction, resulting from ileo-caecal intussusception with the lead point being a lipoma of the terminal ileum. Ileocaecal resection with primary anastamosis was performed with histology confirming lipoma. Intussusception is not a common cause for intestinal obstruction in adults and is best diagnosed with CT scan. Surgical resection remains the definitive treatment in adult intussusception.
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Affiliation(s)
| | | | - Basma Alsayed
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
| | - Kamel Alawadhi
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
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Klinger C, Riecken B, Dietrich CF, Dirks K, Caca K, Fröhlich E. Use of Ultrasound in the Diagnostic Work-Up of Adult Intussusception - A Multicenter Retrospective Analysis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2020; 41:418-427. [PMID: 29975971 DOI: 10.1055/a-0604-2676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To evaluate the use of ultrasound (US) in the diagnostic work-up of adult intussusception (AI). METHODS This multicenter study includes 26 consecutive patients diagnosed with AI between January 2010 and November 2017. A retrospective chart analysis was conducted with a focus on abdominal US findings and diagnostic accuracy of different imaging modalities (ultrasound, computed tomography (CT), magnetic resonance imaging). If available, surgical and pathological findings served as the gold standard (76.9 %). US examiners certified according to DEGUM grade 2 or 3 were classified as experts. Otherwise, they were regarded to have basic skills. RESULTS During diagnostic work-up, 92.3 % underwent abdominal US. US was the first-line imaging modality in 88.5 % of cases. The accuracy regarding the detection of AI (85 %), correct localization (95 %) and detection of complications (100 %) was excellent and comparable with CT (81 %, 90.5 %, and 91.7 %) when performed by experts. 72.7 % of tumorous lead points were detected by experienced examiners. In contrast, AI was detected in only 45.5 % of cases by examiners with basic skills. AI was diagnosed prior to surgery in all patients. CONCLUSION US is reliable in the diagnostic work-up of AI when performed by experienced examiners with high-quality equipment. US, CT and MRI should be used in a complementary fashion since combination provides excellent sensitivity regarding the detection and correct localization of AI as well as the detection of complications. The impact of real-time imaging is illustrated by supplementary videos.
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Affiliation(s)
- Christoph Klinger
- Department of Gastroenterology, Hepatology and Oncology, Klinikum Ludwigsburg, Germany
| | - Bettina Riecken
- Department of Gastroenterology, Hepatology and Oncology, Klinikum Ludwigsburg, Germany
| | - Christoph Frank Dietrich
- Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim gGmbH, Bad Mergentheim, Germany
| | - Klaus Dirks
- Gastroenterology and Internal Medicine, Rems-Murr-Klinikum Winnenden, Germany
| | - Karel Caca
- Department of Gastroenterology, Hepatology and Oncology, Klinikum Ludwigsburg, Germany
| | - Eckhart Fröhlich
- Internal Medicine I, University hospital Tuebingen, Tübingen, Germany
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Fan WF, Ma G, Li GC, Long J, Xu YH, Guo KJ, Liu Z. Ileocecal intussusception caused by two different tumors - which is the culprit lesion? A case report. World J Clin Cases 2020; 8:2044-2049. [PMID: 32518799 PMCID: PMC7262695 DOI: 10.12998/wjcc.v8.i10.2044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/01/2020] [Accepted: 04/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ileocecal intussusception caused by two different tumors is rare, according to a literature review. We describe a case of a male patient with a cauliflower-like mass in the middle of the transverse colon observed by colonoscopy before surgery. It was considered to be intussusception caused by colon cancer. However, a substantial lipomatous mass was seen in the distal end of the intussusception by computed tomography before surgery, which posed a challenge in the preoperative diagnosis.
CASE SUMMARY We report a 72-year-old male patient with intussusception. The patient underwent right hemicolectomy and cholecystectomy in our hospital on April 29, 2019. During operation, the ileum was inserted into the ascending colon by about 15 cm, and a tumor with a diameter of approximately 3.0 cm was observed in the distal part of the intestine. An atypical liposarcoma/highly differentiated liposarcoma in the adipose tissue was suspected in the postoperative pathology, and a lipoma was diagnosed after MDM2 gene testing. A 4.0 cm × 5.0 cm polypoid mass was seen immediately adjacent to the mass, and the postoperative pathology report suggested a high-level tubular adenoma. The patient was eventually cured and discharged with an uneventful follow-up.
CONCLUSION Intussusception caused by two different types of masses is extremely rare. At present, surgery is the best treatment once intussusception is diagnosed.
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Affiliation(s)
- Wu-Feng Fan
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Gang Ma
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Gui-Chen Li
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Jin Long
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Yuan-Hong Xu
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Ke-Jian Guo
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Zhe Liu
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Lee JE, Chiu L, Tan MC. A Unique Case of Massive Colonic Distention. Gastroenterology 2020; 158:e5-e6. [PMID: 31738911 DOI: 10.1053/j.gastro.2019.10.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 10/18/2019] [Indexed: 12/02/2022]
Affiliation(s)
| | | | - Mimi C Tan
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
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Zaidi SR, Khan ZH, Mukhtar K, Ahmed MM, Syed SH. A Case of Intussusception in a Patient with Marijuana Use: Coincidence or Possible Correlation? Cureus 2020; 12:e7493. [PMID: 32368425 PMCID: PMC7193230 DOI: 10.7759/cureus.7493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
'Intussusception' means invaginating or telescoping and is caused by any condition that disrupts the normal physiological mechanism of intestinal peristalsis. Intussusception is rare in adults with an incidence of two to three cases per population of 1,000,000 annually. The most common cause of intussusception in adults is a neoplasm. In this case report, we are describing the case of a 22-year-old female with a past medical history of chronic constipation and a 60-pound unintentional weight loss who presented with the sudden onset of progressively worsening, severe abdominal pain associated with nausea, episodes of non-bloody, non-bilious emesis, and dark-colored loose stools. The patient's social history was significant for extensive marijuana use for more than one year. Upon presentation, vitals were significant for mild bradycardia and examination was remarkable for diffuse abdominal pain. Initial laboratory testing was positive only for lactic acidosis. A computed tomography (CT) scan of the abdomen and pelvis revealed small bowel intussusception in the left hemiabdomen, along with periportal edema, and a small amount of pericholecystic fluid. The patient underwent both upper endoscopy and colonoscopy but no lead points for the intussusception could be identified. The patient responded to conservative management, including bowel rest, which resulted in the resolution of the intussusception on a follow-up small bowel series. Intraluminal irritants as the possible etiology of intussusception should be considered in the absence of a pathological lead point. Marijuana has been shown to act on various bowel segments and disrupts gastrointestinal motility through inhibition of cholinergic mechanisms. We believe the chronic use of marijuana could be the possible etiology of intussusception observed in our patient. Therefore, this case brings attention to the adverse effects of marijuana in light of increasing legalization and the increasing therapeutic use of marijuana and its derivatives.
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Affiliation(s)
| | - Zarak H Khan
- Internal Medicine, St. Mary Mercy Hospital, Livonia, USA
| | - Kashif Mukhtar
- Internal Medicine, St. Mary Mercy Hospital, Livonia, USA
| | - Munis M Ahmed
- Internal Medicine, St. Mary Mercy Hospital, Livonia, USA.,Internal Medicine, King Edward Medical University, Lahore, PAK
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Sainaba SM, Ganapath AS, Sivakumar A, Gayathri AV, Yadev IP. Adult Intussusception at a Tertiary Care Center: A Retrospective Study. Niger J Surg 2020; 26:63-65. [PMID: 32165839 PMCID: PMC7041356 DOI: 10.4103/njs.njs_38_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/22/2019] [Accepted: 12/02/2019] [Indexed: 01/06/2023] Open
Abstract
Background: In adults, the majority of cases of intussusception are due to malignancy. Aims: The aim of the study is to describe the pattern of intussusception in the adult population diagnosed and treated at a tertiary care center. Subjects and Methods: Study Design: This is a retrospective cross-sectional study based on chart review, and data collection was made from the computer database and inpatient case records. Study Setting: Adult intussusception cases diagnosed and treated at a tertiary care referral center in South India. All inpatient case sheets including investigations and histopathology information on the computer database of all patients diagnosed with intussusception in the period of August 2012 to July 2016 were retracted based on a pretested and standardized form. Demographic data and other baseline data were summarized with descriptive statistics. SPSS software was used for data analysis. Results: Of the 77 patients, 47 (61%) were male. The common presentations were abdominal pain (95%), vomiting (64%), and rectal bleeding (29%). Common examination findings were abdominal tenderness (45%), guarding (39%), and abdominal mass (38%). On ultrasonography, fifty (65%) patients had intussusception with ileocolic (25) as the most common type. Computed tomography abdomen was taken for 28 (36%) patients, in which 23 (82%) had intussusception with ileocolic (9) as the most common type. Surgery was done for 53 (69%) patients, and the most common procedure was right hemicolectomy (25) followed by resection and anastomosis of the small bowel (23). Intraoperatively, 42 (79%) patients had intussusception with ileocolic (23) as the most common type. Intraoperatively, 14 (26%) patients had a bowel gangrene. Biopsy-proven cause for intussusception was present in 46 patients, with malignancy (21) as the most common cause. The patients were on regular follow-up. Recurrence of intussusception occurred in six patients of the small bowel intussusception who had polyposis. Conclusions: Adult intussusception is often associated with malignancy. Hence, a formal resection without reduction is needed and surgery should be done following oncological principles.
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Affiliation(s)
- Sulfekar Meera Sainaba
- Department of General Surgery, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Aravind S Ganapath
- Department of General Surgery, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Anoop Sivakumar
- Department of General Surgery, Government Medical College, Thiruvananthapuram, Kerala, India
| | - A V Gayathri
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
| | - I P Yadev
- Department of General Surgery, Government Medical College, Thiruvananthapuram, Kerala, India
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Abe I, Saito M, Ikeda T, Fukuda R, Tanaka A, Rikiyama T. Ileectomy performed on a case of adult intussusception due to inversion of Meckel's diverticulum. J Surg Case Rep 2020; 2020:rjz367. [PMID: 31976058 PMCID: PMC6963164 DOI: 10.1093/jscr/rjz367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 11/25/2019] [Indexed: 11/13/2022] Open
Abstract
We report a rare case of adult intussusception caused by an inverted Meckel’s diverticulum with ectopic pancreatic tissue. A 43-year-old woman was referred to our hospital with complaints of abdominal distention, intermittent abdominal pain and nausea that she experienced 3 months ago. Abdominal computed tomography scans demonstrated ileo-ileal intussusception that contained a tumor with fat density as the lead point. Laparoscopic-assisted partial resection of the small intestine was performed. The surgical specimen showed an elongated polypoid lesion invaginated into the intestinal tract indicating an inverted Meckel’s diverticulum. Pathological findings showed a true diverticulum that ran antimesentrically, with tall columnar epithelium, a mucous gland and an islet of Langerhans. The postoperative period was uneventful, and she was discharged on the ninth postoperative day.
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Affiliation(s)
- Iku Abe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Taro Ikeda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rintaro Fukuda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Akira Tanaka
- Department of Pathology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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Kushiya H, Ebihara Y, Nakanishi Y, Asano T, Noji T, Kurashima Y, Murakami S, Nakamura T, Tsuchikawa T, Okamura K, Shichinohe T, Hirano S. Jejunal intussusception at the jejunojejunostomy after laparoscopic total gastrectomy: A case report. Asian J Endosc Surg 2020; 13:99-102. [PMID: 30811849 DOI: 10.1111/ases.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 12/12/2018] [Accepted: 01/20/2019] [Indexed: 11/30/2022]
Abstract
Jejunal intussusception at the jejunojeunostomy after total gastrectomy with Roux-en-Y (RY) reconstruction is rare. We describe a case of jejunal intussusception at the jejunojeunostomy that developed in a 60-year-old woman who had undergone laparoscopic total gastrectomy with RY reconstruction for gastric cancer 4 years ago. The main presenting complaint was recurrent epigastric pain. Abdominal computed tomography showed a typical target sign suspected of antegrade intussusception into a blind loop at the jejunojeunostomy. We performed a laparoscopic operation, which revealed no intussusception or adhesions. We noted that the blind loop of the bilio-pancreatic limb was longer and expanded. We divided the blind loop at the distal side of the jejunojeunostomy and performed suture plication between the bilio-pancreatic limb and alimentary limb. Therefore, the appropriate length of the blind loop and the size of the jejunojeunostomy site should be carefully determined during RY reconstruction.
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Affiliation(s)
- Hiroki Kushiya
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yuma Ebihara
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yoshitsugu Nakanishi
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Toshimichi Asano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Takehiro Noji
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Soichi Murakami
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Toru Nakamura
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Takahiro Tsuchikawa
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Keisuke Okamura
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Toshiaki Shichinohe
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
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Small Bowel Obstruction Secondary to Intussuscepted Meckel's Diverticulum in an Adult. Case Rep Surg 2019; 2019:3241782. [PMID: 31871815 PMCID: PMC6906793 DOI: 10.1155/2019/3241782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/31/2019] [Accepted: 11/18/2019] [Indexed: 11/17/2022] Open
Abstract
Intussusception secondary to inverted Meckel's diverticulum resulting in intestinal obstruction is rare. The following is a case report that discusses a 29-year-old female who posed diagnostic uncertainty for the treating surgical team and ultimately underwent emergency surgery for the management of intestinal obstruction. Small bowel intussusception was diagnosed preoperatively on abdominal computer tomography (CT). At operation, it was found to be secondary to inverted Meckel's diverticulum with histopathology confirming the diagnosis.
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Tabone RA, DeGreve T, Webb P, Yuide P. Jejuno-jejunal intussusception secondary to diffuse intestinal lipomatosis. J Surg Case Rep 2019; 2019:rjz354. [PMID: 31824643 PMCID: PMC6892380 DOI: 10.1093/jscr/rjz354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/03/2019] [Indexed: 11/12/2022] Open
Abstract
A 25-year-old man presented to the emergency department with severe abdominal pain and vomiting. He had previously presented 10 days prior with similar symptoms. Computed tomography imaging showed a large jejuno-jejunal intussusception. Multiple intestinal masses were identified intraoperatively with the rare diagnosis of intestinal lipomatosis later confirmed via histopathology. Diagnosis and management of rare surgical pathologies is always challenging. Intussusception should always be considered as a differential diagnosis for abdominal pain in adults, as adult intussusception is typically due to a structural abnormality with majority of cases requiring surgical intervention. Exploratory laparotomy with segmental resection and primary anastomosis proved to be a successful approach in our case, with the patient having an uneventful recovery. Follow-up has consisted of gastrointestinal endoscopy and colonoscopy, which have not demonstrated any further lipomas.
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Affiliation(s)
- Renee Angela Tabone
- General Surgery, Queensland Health, Logan Hospital, Brisbane, QLD 4131, Australia; Griffith University, School of Medicine, Gold Coast, QLD 4215, Australia
| | - Tom DeGreve
- General Surgery, Queensland Health, Logan Hospital, Brisbane, QLD 4131, Australia; Griffith University, School of Medicine, Gold Coast, QLD 4215, Australia
| | - Peita Webb
- General Surgery, Queensland Health, Logan Hospital, Brisbane, QLD 4131, Australia; Griffith University, School of Medicine, Gold Coast, QLD 4215, Australia
| | - Peter Yuide
- General Surgery, Queensland Health, Logan Hospital, Brisbane, QLD 4131, Australia; Griffith University, School of Medicine, Gold Coast, QLD 4215, Australia
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Colorectal Intussusception Due to Rectosigmoid Junction Cancer: A Unique Surgical Challenge? J Gastrointest Cancer 2019; 51:639-642. [PMID: 31713812 DOI: 10.1007/s12029-019-00326-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dragović S. COLON-COLONIC INVAGINATION CAUSED BY CECUM CANCER – A CASE REPORT. ACTA MEDICA MEDIANAE 2019. [DOI: 10.5633/amm.2019.0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Filiberto AC, Loftus TJ, Tan SA, Read TE, Iqbal A. Sigmoido-rectal intussusception. SAGE Open Med Case Rep 2019; 7:2050313X19856242. [PMID: 31217975 PMCID: PMC6558527 DOI: 10.1177/2050313x19856242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/20/2019] [Indexed: 12/31/2022] Open
Abstract
Rectal prolapse is usually of benign etiology. Rarely, sigmoido-rectal
intussusception results from a malignant lead-point. We report the case of a
patient with a partially obstructing sigmoid cancer causing a full thickness
rectal prolapse requiring surgical intervention. An 82-year-old woman presented
with 1 week of rectal bleeding, fecal incontinence, and weight loss. Computed
tomography identified sigmoido-rectal intussusception. Colonoscopic biopsy
revealed high-grade dysplasia. Magnetic resonance imaging demonstrated a 6-cm
mass forming the lead point of the intussusceptum with epiploic appendages seen
within the rectal lumen. She underwent laparoscopic low anterior resection with
final pathology consistent with T2N0 adenocarcinoma, and recovered well. Among
adult patients with rectal prolapse, suspicion for underlying malignancy should
prompt a thorough investigation to inform the decision for resection, which may
be safely performed by minimally invasive techniques.
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Affiliation(s)
- Amanda C Filiberto
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
| | - Tyler J Loftus
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
| | - Sanda A Tan
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
| | - Thomas E Read
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
| | - Atif Iqbal
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
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Missed case of intussusception, a rare cause of abdominal pain in adults: A case report emphasizing the imaging findings and review of the literature. Radiol Case Rep 2019; 14:906-910. [PMID: 31193563 PMCID: PMC6536620 DOI: 10.1016/j.radcr.2019.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 12/27/2022] Open
Abstract
Intussusception, a process whereby a segment of the intestine telescopes into the adjoining intestinal lumen, is a rare source of pain in adults that present with nonspecific abdominal pain. Imaging is the mainstay for diagnosis, which requires prompt and accurate interpretation to prevent complications. The following report details the misdiagnosis of intussusception in a 54-year-old male, whom presented to the emergency department with a 4-day history of nonrelenting abdominal pain, nausea, vomiting, and constipation. Following blood tests, chest, and abdominal imaging, the patient was discharged with a suspected passed renal stone. He soon represented to the General Practitioner, however, with equivalent pain; prompting a review of the images. It was apparent that the initial radiologist failed to recognize the subtle presence of intussusception. This case highlights the necessary consideration of intussusception as a differential diagnosis in adult patients presenting with intermittent abdominal pain. The case further emphasizes that radiologists should be familiar with the subtler signs of intussusception.
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Choe J, Wortman JR, Michaels A, Sarma A, Fulwadhva UP, Sodickson AD. Beyond appendicitis: ultrasound findings of acute bowel pathology. Emerg Radiol 2019; 26:307-317. [PMID: 30661212 DOI: 10.1007/s10140-019-01670-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 01/03/2019] [Indexed: 12/14/2022]
Abstract
Bowel pathology is a common unexpected finding on routine abdominal and pelvic ultrasound. However, radiologists are often unfamiliar with the ultrasound appearance of the gastrointestinal tract due to the underutilization of ultrasound for bowel evaluation in the USA. The purpose of this article is to familiarize radiologists with the characteristic ultrasound features of a variety of bowel pathologies. Basic ultrasound technique for bowel evaluation, ultrasound appearance of normal bowel, and key ultrasound features of common acute bowel abnormalities will be reviewed.
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Affiliation(s)
- Jihee Choe
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Jeremy R Wortman
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Aya Michaels
- Department Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Asha Sarma
- Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Urvi P Fulwadhva
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Aaron D Sodickson
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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