• adult intussusception
• appendiceal mucocele
• case report
• intestinal obstruction
• laparotomy

• Abdominal CT diagnosis
• Adult intussusception
• Colo-colic intussusception
• Colonic tumor
• Intestinal obstruction
• Surgical resection

• adult intussusception
• appendectomy
• case report
• ileocolic intussusception
• ultrasound

• bowel obstruction
• incarcerated incisional hernia
• incisional hernia
• intussusception
• surgical management of intussusception

• Colo-colónica
• Colocolonic
• Ileocolic
• Ileocolónica
• Intussusception
• Intususcepción

• Adult
• Humans
• Adolescent
• Young Adult
• Middle Aged
• Aged
• Aged, 80 and over
• Intussusception/diagnosis
• Intussusception/surgery
• Retrospective Studies
• Treatment Outcome
• Surgeons
• Neoplasms

• Case report
• Colicky pain
• Colon
• Intussusception
• Right iliac fossa mass

• Gastroenterology
• Gastrointestinal surgery
• General surgery

• Female
• Humans
• Intussusception/etiology
• Intussusception/surgery
• Intussusception/diagnosis
• Colectomy/adverse effects
• Colonoscopy/adverse effects
• Intestinal Polyps/surgery
• Intestinal Polyps/complications
• Laparoscopy/adverse effects
• Anastomosis, Surgical/adverse effects

• acute abdominal pain
• adult
• intussusception
• point-of-care ultrasound
• ultrasonography

• calcified fibrous tumor
• jejunum
• leiomyoma
• mesenchymal tumor
• pseudotumor

• Double-balloon enteroscopy
• Intussusception
• Peutz-Jeghers syndrome
• Risk assessment

• adult intussusception
• case report
• renal cell carcinoma
• solitary metastasis
• surgical oncology

• Bypass
• Cholecystitis
• Complications
• Intussusception
• Y-de-Roux

• Intussusception
• Lipoma
• Small bowel obstruction

Retrograde intussusception (RI) is a rare long-term complication of gastric bypass surgery, which usually happens within the first few years after operation. The clinical presentation is vague with overlapping symptoms of bowel obstruction or ischemia. This is a case of a 37-year-old lady who presented with severe abdominal pain. She has background of Roux-en-Y gastric bypass surgery 23 years ago. She underwent emergency laparotomy, bowel resection and Roux-en-Y reconstruction due to finding of ischemic bowel segment. Unfortunately, she had recurrent presentation of RI after 6 months and similar operation was necessitated. She recovered well post-operatively, but there was no definitive cause established for the recurrence. While RI remains a rare diagnosis, clinicians should have high index of suspicion in encountering patients with acute abdomen post gastric bypass surgery. Early imaging is required for the diagnosis and surgical intervention is often warranted.

• adhesive intestinal obstruction
• bowel intussusception
• neurofibromatosis type 1

• Meckel's diverticulum
• adenocarcinoma
• intussusception
• young woman

• Acute intestinal intussusception
• Jejunostomy tube
• Occlusion

Intussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should undergo surgery. Here we describe a case of ileal inflammatory fibroid polyp (IFP), presenting with ileo-ileal intussusception and obstruction.

A 54-year-old Caucasian woman presented for acute abdominal pain. A radiography and a CT of the abdomen were performed, which showed signs of occlusion due to an ileo-ileal intussusception. An urgent laparoscopy was performed, the intussusception was extracorporeally reduced, the ileal segment involved was resected, and an ileo-ileal anastomosis was performed. The intussusception seemed to be caused by a 3-cm intra-mural lesion.

Intussusception is a surgical concern. While most cases are idiopathic in children, 90% of adult intussusceptions are caused by underlying diseases. Therefore, intussusception in adults should undergo surgery. Radiology is necessary for the diagnosis: the CT scan helps localizing the lesion and shows pathognomonic signs. This case report analyzes an intussusception caused by an inflammatory fibroid polyp. Accurate diagnosis of IFP is only possible with histopathological examination, helped by immunohistochemistry. The differential diagnosis is important because some lesions are malignant.

We reported a case of intussusception caused by an IFP. The diagnosis was made with a CT scan together with intraoperative findings and histopathological examination, which excluded potential differential diagnoses. The patient underwent an explorative laparoscopy, with an ileal resection and anastomosis. Due to the risk of malignancy, surgery is mandatory.

Intussusception in adults is a challenging diagnosis that often requires a high degree of suspicion. In adults presenting with symptoms, almost 90% have underlying neoplasms. Most frequently, the presentation will include nonspecific abdominal pain, vomiting, and mucoid hematochezia. In this case, we present a 39-year-old female with a rare presentation of chronic, recurrent right upper quadrant abdominal pain over a 5-month interval. The misleading presentation with which the patient presented led to a delay in diagnosis and treatment of colon malignancy and serves to advocate for intussusception as a differential for adult patients presenting with obstructive symptoms of unknown origin and recurrent abdominal pain. Such cases should persuade physicians to plan prompt surgical intervention as to not delay optimal diagnostic and therapeutic outcomes.

• Adenocarcinoma
• Case report
• Gastroenterology
• Intussusception

Peutz-Jeghers syndrome (PJS) is an autosomal dominant inheritance characterized by intestinal hamartomatous polyps and hyperpigmented mucocutaneous macules. Bleeding, bowel obstruction, and intussusception are the most common complications in PJS patients. Individuals are infrequently present for the first time with bowel obstruction secondary to intussusception. Intestinal intussusception presentation is often observed clearly on multidetector computed tomography (MDCT) with characteristic findings, such as “target” and “pseudo-kidney” signs, and sometimes shows the cause of lead-point polyp. A complemental examination is needed to attain more diagnostic symptoms of this disorder, including pigmented spots on the oral cavity and lips, family history with multiple gastrointestinal polyps. Here, we report a case of a 17-year-old male who showed traits of Peutz-Jeghers syndrome. However, the diagnosis was not made until he later developed bowel obstruction caused by an ileo-ileal intussusception manifestation on MDCT and eventually proved in typical hamartoma on postoperative histopathology.

• image findings
• intussusception
• multidetector computed tomography
• peutz-jeghers syndrome
• small bowel obstruction

Intussusception is a rare long-term complication following bariatric surgery. With unclear risk factors and a variable presentation, intussusception is often diagnosed in emergency departments on cross-sectional imaging. Due to the nature of the disease process, prompt involvement of a bariatric surgeon and operative intervention offers the best outcome. Here, we discuss two similar cases of jejunojejunal intussusception following open Roux-en-Y gastric bypass and abdominoplasty that were managed with operative reduction of the involved bowel.

• emergency medicine
• gastroenterology
• radiology
• small intestine
• surgery

Appendiceal adenocarcinomas, although rare, usually present as slow-growing masses. Rarely, do they rapidly enlarge into large abdominal masses over a short period of time. Generally, we attribute rapidly growing abdominal masses to sarcomas, desmoid tumors, or gynecological masses. We present a case of a rapidly growing appendiceal adenocarcinoma in an elderly patient.

We report a case of an 83-year-old-male who presented with a one-month history of abdominal pain. A computer tomography (CT) scan identified a lower pelvic mass measuring 7.39 cm × 5.40 cm. A biopsy was done which revealed appendiceal carcinoma. A plan for radiotherapy to reduce the tumor size was made and the patient was discharged. However, the patient returned after three weeks due to worsening abdominal pain and a CT scan identified a significant enhancement in the tumor size. The patient underwent debulking surgery. Pathology of the specimen identified adenocarcinoma of the appendix.

A rapidly growing carcinoma of the appendix is rare as they are known to have a slow growth rate. A swift diagnosis and intervention are required as these rapidly enhancing neoplasms in the abdomen can become unresectable and metastasize. Although there are various methods of treatment for appendiceal carcinomas, the rapid growth rate and lack of response to radiation required debulking surgery.

There exist a myriad of differential diagnoses for a rapidly growing mass in the abdomen. We are presenting the first documented case of a rapidly growing appendiceal adenocarcinoma. Surgeons should be aware of the variety of differentials in such cases.

•

Appendiceal carcinomas with such a rapid enhancement in size are quite rare.

• Abdominal mass
• Adenocarcinoma
• Appendiceal carcinoma
• Appendix
• Rapidly enlarging
• Right hemicolectomy

• Endoscopy
• Malignancy
• Small bowel

• Abdominal pain
• Adenocarcinoma
• Bowel intussusception

• Adenocarcinoma/complications
• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Aged, 80 and over
• Female
• Humans
• Ileal Diseases/diagnostic imaging
• Ileal Diseases/etiology
• Ileal Diseases/surgery
• Ileal Neoplasms/complications
• Ileal Neoplasms/diagnostic imaging
• Ileal Neoplasms/pathology
• Ileal Neoplasms/surgery
• Ileocecal Valve/diagnostic imaging
• Ileocecal Valve/pathology
• Ileocecal Valve/surgery
• Intussusception/diagnostic imaging
• Intussusception/etiology
• Intussusception/surgery
• Neoplasm Staging
• Treatment Outcome

• Adult
• Diagnosis
• Intussusception
• Management
• Surgery

• enteral nutrition
• feeding jejunostomy
• intussusception
• jejunojejunal intussusception
• jejunostomy tube

• Intussusception
• Invagination
• Roux-en-Y gastric bypass

Intussusception is uncommon among adults. The condition, which is defined as a telescoping of a proximal portion of the small or large bowel into the lumen of an adjacent segment of bowel, is most commonly seen in children. Among pediatric cases, the majority is benign and treated non-operatively. However, in adults, intussusception is the result of pathologic and often malignant lead points in the majority of cases. This makes surgical resection and tissue diagnosis the only definitive treatment option. While the majority of adult intussusception cases involves a pathologic lead point, a small percentage is idiopathic, without an identifiable lead point. We present a 32-year-old man with acute on chronic abdominal pain and cross-sectional imaging that identified jejunal intussusception, which was confirmed in operating room and resected. Interestingly, no pathologic lead point was identified on pathologic review. We discuss our diagnostic approach, surgical decision making and final tissue diagnosis.

Adult intussusception is recognized as an abdominal emergency. More than 90% of adult patients with intussusception have distinct causes that are related to benign or malignant tumors. In contrast, idiopathic intussusceptions, which are observed in children, are rare conditions in adult. Especially, colo-colonic idiopathic intussusceptions are rare among them. Surgery is traditionally considered the primary treatment option. Recently, laparoscopic surgery has been reported to be safe and feasible. However, laparoscopic surgical reduction, which is a common procedure in pediatric surgery, is not common in adult intussusception.

We report a 34-year-old man who presented with sudden abdominal pain. Computed tomography revealed the target sign in the transverse colon. There was no evidence of bowel obstruction, bowel wall edema, or tumor. We diagnosed idiopathic intussusception and selected laparoscopic procedure because of the strong abdominal pain experienced by the patient. There were no signs of perforation, bowel wall ischemia, or tumor in abdominal cavity. We confirmed idiopathic colo-colonic anterograde intussusception. Laparoscopic surgical reduction was achieved by a combination of delicate direct pressure on the anal side of the transverse colon and gentle pulling on the oral side. The patient’s postoperative course was uneventful.

We achieved successful surgical reduction laparoscopically because of an accurate preoperative diagnosis based on characteristic computed tomography features and appropriate surgical technique. Laparoscopic procedure and surgical reduction is considered to be an effective treatment strategy for adult idiopathic intussusceptions with severe symptoms.

• Emergency surgery
• Idiopathic intussusception
• Laparoscopy

• Intussusception
• Jejunostomy
• Lead point
• Target sign

•

Lymphangioma is a benign tumor that rarely arises in gastrointestinal tract.

Adult intussusception and lymphangioma in gastrointestinal tract are uncommon entities respectively. Recurrent intussusception due to lymphangioma of the small intestine is extremely rare and mimics adhesive small bowel obstruction (SBO).

A 37 year old man presented with acute abdominal pain and vomiting. He had been admitted several times for adhesive SBO after laparoscopic cholecystectomy at age 21. He was initially managed with a long tube placement, with which he used to get well. This time, the symptoms once relieved but soon relapsed, so an exploratory laparotomy was performed. Intraabdominal adhesiolysis was performed alongside the excision of a small segment of damaged jejunum. Intussusception of jejunum was noted and its reduction was also performed. Unfortunately, the symptoms continued after the operation, and computed tomography revealed a recurred intussusception of the jejunum. A reoperation with an additional resection of small intestine surrounding intussusception was performed. The symptoms subsided after the second operation and the patient was discharged. Pathological examination revealed lymphangioma within the affected lumen.

Intussusception in an adult is often caused by a tumor but can be caused by postoperative adhesion. The reduction is a potential option of treatment if there is no tumor suspected, but sometimes it would be uneasy to affirm the non-existence of tumors.

We present this rare case of recurrent jejuno-jejunal intussusception caused by small bowel lymphangioma with review of literature. Taking the possibility of recurrence and malignancy into account, the resection should always be considered in such patients.

• Abdominal distension
• Abdominal pain
• Adhesive small bowel obstruction
• Adult intussusception
• Case report
• Small bowel lymphangioma

• intussusception
• ileocolic
• lipoma
• adult

• Adult
• Colonic Diseases/etiology
• Female
• Humans
• Ileal Diseases/complications
• Ileal Diseases/surgery
• Intussusception/etiology
• Lipoma/complications
• Lipoma/surgery

• complication
• gastrointestinal anastomosis
• gastrojejunostomy tube
• pancreatoduodenectomy
• postoperative intussusceptions

• Adult
• Aged
• Anastomosis, Surgical/adverse effects
• Enteral Nutrition/adverse effects
• Female
• Humans
• Intestinal Diseases/epidemiology
• Intestinal Diseases/etiology
• Intussusception/epidemiology
• Intussusception/etiology
• Male
• Middle Aged
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Postoperative Period
• Prevalence
• Retrospective Studies

• Adults
• Nigeria
• etiology
• intussusception
• management

Retrograde jejuno-jejunal intussusception is a rare complication of bariatric surgeries. It causes acute sudden symptoms that require immediate surgical intervention. We report a case of a 46-year-old female who underwent Roux-en-Y gastric bypass (REYGP) 3 years prior. The patient presented to the emergency department with acute sudden abdominal pain, nausea and vomiting. Laparoscopically, intussuscepting small bowel segment was found gangrenous, and it was resected and end-to-end anastomoses were fashioned. The postoperative course was uneventful, and the patient remained asymptomatic for the 12 months of follow-up. Patients with retrograde intussusception experience an intolerable severe pain that necessitates surgical intervention. The etiology of intussusception as a complication after REYGP is unclear, yet theoretically some possible etiologies exist. The initial diagnosis of retrograde intussusception is made based on abdominal computed tomography. Early intervention significantly reduces morbidity and mortality.

• abdominal pain
• ileum
• intussusception

• Adult
• Female
• Humans
• Ileal Diseases/diagnosis
• Ileal Diseases/surgery
• Ileocecal Valve
• Intussusception/diagnosis
• Intussusception/surgery
• Tomography, X-Ray Computed

• Gastro-jejunostomy tube
• Jejuno-jejunal intussusception
• Surgical reduction of intussusception

• gastroenterology
• general surgery

• Adult
• Colon
• Colonoscopy
• Iatrogenic disease
• Intussusception