Adult Intussusception Research Articles

Adult Ileo-ileal Intussusception Caused by an Ileal Lipoma

A 32-year-old obese patient presented with a history of intestinal obstruction. A contrast-enhanced computed tomography (CECT) scan revealed ileo-ileal intussusception. The patient underwent a right hemicolectomy, and the cause of the intussusception was identified as an ileal lipoma. This case highlights the importance of considering lipomas as a potential cause of intussusception in adults, particularly when they present with intestinal obstruction

Jejuno-jejunal intussusception in an adult due to inflammatory fibroid polyp: Tale of two unusual cases.

Intussusception in adults is rare, accounting for 1-2% of intestinal obstruction, often caused by neoplasia. Jejuno-jejunal intussusception is especially uncommon and usually linked to benign lesions. Symptoms are vague, including colicky abdominal pain, vomiting and gastrointestinal bleeding, often delaying diagnosis until exploratory laparotomy. We present two cases of adult jejuno-jejunal intussusception caused by inflammatory fibroid polyps (IFPs), rare benign submucosal tumours mostly found in the stomach and rarely (4.3%) in the jejunum. The first case involved a 17-year old male with abdominal pain, melaena, anaemia and renal dysfunction; surgery revealed a jejunal mass, confirmed as IFP. The second case was a 34-year old female with bowel obstruction from a jejunal mass also identified as IFP. Imaging may mimic malignancy such as gastro-intestinal stromal tumor (GIST) or lymphoma, but histopathology confirms diagnosis. Surgical resection is curative with excellent prognosis.

Management of a case of acute intussusception in rural Guinea

Introduction: The aim of this study was to describe the therapeutic aspects of a case of acute intussusception in adults. Clinical case: this is a 20-year-old lady, housewife residing in doghol Touma 100km, (pita), admitted on 23/09/2023, who presented abdominal pain and abdominal distension of progressive evolution for 48 hours, all pleading in favor of an acute intestinal obstruction. Resuscitation and a preoperative assessment were carried out, including abdominal ultrasound, ASP and biology. Under general anesthesia, we performed a median laparotomy, identified an ileo-ileal intestinal intussusception with loop necrosis and proceeded to a segmental resection of the necrotic intestine 1.5 meters followed by an immediate restoration of digestive continuity by a termino-terminal ileo-ileal anastomosis. Complementary appendectomy, toilet drain in the Douglas fir. The post-operative effects were simple. The length of hospital stay was 7 days. Conclusion: it is an infant condition, rare in adults. The diagnosis is most often intraoperatively aided by imaging. The prognosis is linked to the precocity of treatment. Keywords: acute, intestinal, intussusception, CEP, Guinea.

Malignant gastrointestinal neuroectodermal tumor (GNET) presenting as Ileocaecal intussusception: A rare cause of acute intestinal obstruction in adults

GNET is an exceptionally rare and aggressive mesenchymal tumor of the gastrointestinal tract, characterized by EWSR1 gene rearrangements. This report describes a unique case of GNET originating from the ileum of a 52-year-old male, presenting as acute intestinal obstruction due to ileocaecal intussusception. The patient experienced abdominal distension, pain, and vomiting for three days. Imaging revealed intussusception, prompting emergency laparotomy. Intraoperatively, a polypoidal mass was identified in the distal ileum as the lead point. Surgical resection of tumor with ileo-ileal anastomosis was performed successfully, and the post-operative course was uneventful. Gross pathology showed a well-circumscribed, submucosal mass arising from the muscularis propria of the ileum, with hemorrhagic and necrotic changes. Histologically, the tumor showed spindle cells with pleomorphic nuclei, arranged in fascicles and interspersed with stag horn-type vasculature. Immunohistochemistry ruled out differential diagnosis such as GIST and leomyoma, with negative DOG1, CD117, and DESMIN markers. Strong CD34 positivity confirmed the diagnosis of Solitary Fibrous Tumor. Risk stratification classified the tumor as low risk. Interestingly, on postoperative follow-up after 4 months, the patient presented with multiple subcutaneous swellings of various sizes over the extremities. FNAC of the swellings surprisingly revealed histopathological features positive for S100, CK8/18 (scattered cells). Tumor cells were negative for SMA, DESMIN, HMB45, SOX10, MELAN A, CD117, DOG1, CK, GATA3, PAX8, HEPAR, CDX2, SATB2, ALK, Synaptophysin, and WT1. KI67 index showed 50%, leading to differential diagnosis of malignant GI neuroectodermal tumor, Malignant peripheral nerve sheath tumor, and sarcomatoid carcinoma. This case underscores the importance of considering rare neoplastic etiologies in adult intussusception. Comprehensive diagnosis involved clinical assessment, radiological imaging, histopathology, and immunohistochemistry. Due to its rarity and aggressive nature, GNET poses diagnostic and therapeutic challenges, necessitating awareness and a multidisciplinary approach.

Case report of a rare variant of adult intussusception with delayed presentation: idiopathic ileocecal colic intussusception

Case report of a rare variant of adult intussusception with delayed presentation: idiopathic ileocecal colic intussusception

Ileocolic Intussusception in Adults: A Rare Presentation of an Underlying Malignancy.

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Idiopathic intussusception in an adult patient with aplastic anemia: a case report

Intussusception in adults is a rare disease. In most cases, it is associated with an underlying condition. The clinical presentation is nonspecific and may present as an acute, intermittent, or chronic condition, most often presenting as an occlusive condition. CT is the diagnostic method of choice. Standard treatment is surgery with resection of the involved segment; however, reduction without resection may be considered in selected cases. In the present case, we report an intussusception in an adult with no evident structural cause. Reduction without resection was decided upon, with no recurrence during follow-up.

Ileus Obstruksi Parsial akibat Intususepsi Ileocaecal dan Tumor Colon Ascendens pada Pasien Perempuan Dewasa

Introduction: Intussusception is a rare condition in adults. It can cause ischemic necrosis, perforation, and peritonitis. Objective: This case report highlights the clinical presentation, diagnosis, and management of bowel obstruction due to intussusception in an adult. Case Illustration: A 43-year-old female patient presented with watery stools mixed with blackish blood, abdominal pain, vomiting, and decreased appetite. Abdominal examination revealed mild distension, reduced bowel sounds, generalized tenderness, and a firm, mobile mass (10 × 10 × 5 cm) in the right lower quadrant. Digital rectal examination showed a dilated rectal ampulla, extra luminal protrusion, and blackish blood-stained feces. Imaging studies confirmed a high-level obstruction and ileocecal intussusception with bowel wall edema. The patient was diagnosed with partial bowel obstruction. Discussion: This unusual case involves a localized tumor in the ascending colon acting as a lead point, leading to ischemia and mucosal necrosis. Accurate diagnosis in adults relies on timely imaging examinations. While plain radiography (BNO) may show signs of intestinal obstruction, its sensitivity is limited. Initial management focuses on stabilizing the patient’s condition by using a gastric tube for decompression, providing intravenous fluids for rehydration, administering analgesics and antibiotics, and, if appropriate, performing a barium or air enema to help reposition the affected segment. Prompt management is essential to prevent serious complications. Conclusion: Adult intussusception is rare and requires diagnosis through history, physical examination, and radiologic studies. Management involves initial medical stabilization and surgical intervention.

Intestinal Invagination in an Adult with Vanek's Tumor: A Case Report

Introduction and Significance: Inflammatory fibroid tumors (IFT) or Vanek's tumors are rare benign neoplasms. They can affect any part of the digestive tract. They are under-diagnosed conditions, usually revealed by a life-threatening complication such as intussusception. The final diagnosis is made on the resection specimen after curative surgery. Case Presentation: A 25-year-old female patient presented with ileo-ileal intussusception revealed by an emergency CT scan. The etiology was unclear, but we suspected small bowel tumor etiology. Emergency surgery was therefore performed and the tumour was resected with margins. The diagnosis of Vanek's tumour was established on pathological examination. Discussion: Inflammatory fibroids are mesenchymal tumours without malignant potential. However, they may be revealed by a dangerous complication requiring emergency surgery. Complete resection is necessary, and anatomopathological examination enables the diagnosis to be made. Conclusion: Surgeons should include IFT among the differential diagnoses of adult ileal intussusception, as it mimics other small bowel tumours. The diagnosis can only be made on pathological examination.

Intestinal intussusception in adults. What are the specificities ?

Intussusception is a primarily pediatric phenomenon that is extremely rare in the adult population. Often overlooked as a differential diagnosis of other abdominal pathologies, its delay in identification can lead to a significant increase in morbidity and mortality. To date, contrast-enhanced abdominal CT consistently proves to be the best method for rapid diagnostic yield. Since the most common cause of the condition is organic and has a significant percentage of malignancy, its management is almost always surgical. In this report, we describe an unusual incidence of intestinal intussusception in an adult that was managed surgically. We hope that this paper will be a valuable addition to the medical literature.

Intussusception in an adult with a history of rectal cancer: a case report

This case report details the clinical journey of a 37-year-old male patient who had undergone rectal cancer surgery five years prior to symptom onset. The patient presented with an abdominal mass and intermittent abdominal pain that had been present for approximately two weeks prior to the current hospitalization for treatment. Through a comprehensive array of diagnostic procedures, notably abdominal CT scans and colonoscopies, the presence and precise location of intussusception were ascertained. The surgical management entailed a radical right hemicolectomy supplemented by preventive measures against recurrence. In the postoperative phase, the patient was administered oral medications and subjected to regular follow-up. This case highlights the diagnostic and therapeutic challenges of adult intussusception in postoperative cancer patients and underscores the importance of a multidisciplinary approach. It also emphasizes the need for tailored treatment strategies to optimize patient outcomes.

Intestinal Lipoma Acting as a Lead Point of Intussusception: A Case Series.

Lipomas represent a rare benign etiology of intussusception in adults, affecting both the small intestine and the colon. Diagnosing intussusception in adults can be challenging, and there are no reports on the use of positron emission tomography/CT (PET/CT) in the diagnosis of lipoma-induced intussusception. This study aimed to preliminarily explore the potential diagnostic utility of 18F-FDG PET/CT in the diagnosis of intussusception caused by lipomas. We conducted a retrospective review of the clinical characteristics and imaging findings of three patients diagnosed with lipoma-induced intussusception using 18F-FDG PET/CT from 2019 to 2023 at our hospital. The three cases presented with diverse clinical presentations and were diagnosed based on PET/CT imaging. Surgical confirmation was obtained in two cases. Lipomas were identified in both the small intestine and the colon, with one case displaying increased metabolic activity on FDG uptake, suggesting a possible link between FDG uptake and clinical severity. Lipoma is a benign cause of intussusception that can occur in both the small intestine and the colon. The symptoms of adult intussusception are often atypical and variable. Imaging modalities, particularly PET/CT, are instrumental in diagnosing intussusception due to lipomas, differentiating between benign and malignant causes, and assessing the severity to inform treatment strategies.

Adult patient with enteric intussusception in the emergency department

Acute abdominal pain in adults is a quite common presentation to emergency departments (EDs) with a broad differential diagnosis. Intussusception in adults is rare, so a high index of suspicion is required to consider it as a differential diagnosis. The most common site of an adult’s intussusception is the small bowel, most commonly due to a well-defined lesion resulting in a lead point. CT abdominal scan is the definitive investigation of choice, leading to prompt diagnosis and early definitive surgical treatment.We present a case of a woman in her 30s, with a previous laparoscopic partial gastrectomy, who presented to our ED with acute onset of abdominal pain associated with dry retching. Her abdominopelvic CT scan showed small bowel obstruction due to enteric intussusception. She underwent an urgent exploratory laparotomy with manual reduction of the intussusception with no adverse immediate postoperative outcomes due to early diagnosis and management.

Avoiding unnecessary bowel resection in adult intussusception: a case report in a patient with multiple prior surgeries utilizing intraoperative enteroscopy.

Intussusception is a rare condition in adults, accounting for approximately 5% of all cases. Unlike pediatric intussusception, which is typically idiopathic, the adult cases are usually associated with an underlying pathology, most commonly malignancies. The surgical intervention is often required, but in small bowel cases, where malignancy is less frequent than in colonic intussusception, the decision regarding resection requires careful consideration. There are no prior reports on the use of intraoperative enteroscopy for small bowel intussusception evaluation. We report the case of a 78-year-old woman who presented with acute abdominal pain, nausea, and bilious vomiting. She had a history of distal gastrectomy with gastroduodenostomy (Billroth-I) and total gastrectomy with Roux-en-Y for gastric ulcer and residual stomach cancer, respectively. Abdominal computed tomography (CT) revealed small bowel intussusception without clear evidence of a lead point lesion. The emergency laparotomy confirmed intussusception 15cm distal to the Roux-en-Y anastomosis, which was manually reduced. The intraoperative enteroscopy revealed inflammatory changes but no malignancy or structural abnormalities. Given the absence of a lead point lesion and the viability of the bowel, resection was avoided. The patient had an uneventful postoperative course and was discharged without complications. Adult intussusception is frequently associated with malignancy, yet cases without a lead point lesion pose a diagnostic and therapeutic challenge. The surgical history, including prior anastomotic procedures, may contribute to the pathogenesis through disrupted intestinal pacemaker activity and retrograde contractions. While second-look surgery can aid in bowel viability assessment, it carries a high complication rate. This case highlights the potential role of intraoperative enteroscopy in evaluating small bowel viability, minimizing unnecessary resection, and improving surgical decision-making. Although further studies are needed to assess its role in optimizing surgical outcomes, intraoperative enteroscopy may be a valuable adjunct in cases of adult small bowel intussusception without an apparent lead point.

Rare case presentation of intestinal intussusception due to leiomyosarcoma

Intussusception is defined as one segment of bowel telescopes into an adjacent bowel segment, which can cause obstruction and even intestinal ischemia. Multiple complications such as intestinal obstruction, intestinal necrosis, and sepsis can occur as result if not treated early. Intussusception is much more common in the pediatric age group and rare in adults.in children it presents with the classic triad of cramping abdominal pain, bloody diarrhea, and a palpable tender mass. In children intussusception mostly likely occurs due to benign causes, whereas in adults cause of intussusception are more likely carcinomas, polyps, diverticulum, strictures, benign neoplasms, or postoperative condition. Most useful diagnostic tools are ultrasonography and computed tomography. We operated a case of adult intussusception due to leiomyosarcoma of small intestine which is even rare. on imaging, ileo-ileal intussusception with dilated proximal bowel loops were found. Exploratory laparotomy done in which large hard polypoidal mass causing ileo-ileal intussusception was found for which ileo-ileal resection & anastomosis done with normal bowel margin of 10 cm on both sides. Patient’s post operative period was uneventful on histopathology, high grade leiomyosarcoma was detected.no clinical or radiological evidence of metastasis found.

Inverted Meckel’s Diverticulm Causing intussecepsetion: Case report

Meckel's diverticulum is a common congenital anomaly of the gastrointestinal (GI) tract but remains a rare cause of massive GI bleeding, especially in adults. Its presentation can mimic other pathologies, often leading to diagnostic challenges. We report the case of a 26-year-old male with no comorbidities who presented with a single episode of massive bloody diarrhoea, dizziness, and fainting. On admission, his haemoglobin dropped from 9.9 g/dL to 6.4 g/dL. Initial investigations, including abdominal ultrasound, upper GI endoscopy, and colonoscopy, failed to identify the source of bleeding. Computed tomography (CT) angiography of the abdomen revealed an ileoileal intussusception with a hyperdense lesion at the apex, suspicious for a neuroendocrine or carcinoid tumour. The patient underwent diagnostic laparoscopy, which confirmed ileoileal intussusception. A mini laparotomy was performed, the affected ileal segment was resected, and ileoileal anastomosis was completed. A prophylactic laparoscopic appendectomy was also conducted. Intraoperatively, the resected ileal segment exhibited a dimpling surface with an intussuscepted mass. Histopathological examination of the resected segment revealed ectopic pancreatic tissue, leading to a retrospective diagnosis of a bleeding Meckel's diverticulum. This case illustrates the diagnostic challenges of adult intussusception with an atypical lead point. The combination of advanced imaging modalities and surgical intervention was crucial in diagnosing and managing this rare condition.

Prolapsed Gangrenous Sigmoido-Rectal Intususception; A Case Report of 65-Year-Old Female Patient

Prolapsed sigmoido-rectal intussusception in adults with a pathologic lead point of colonic lipoma is a rare clini cal condition. Gangrenous prolapsed colonic intussusception is even rarer. Adult intussusception often has a malignant lead point

Characteristics of Adult Intussusception due to Malignancy in Japanese Patients.

Adult intussusception (AI) is often associated with organic diseases. However, few studies have examined the causes of AI in Japanese patients. This study aimed to elucidate the clinical characteristics of AI due to malignancy in Japanese patients. From 2013 to 2021, 54 Japanese patients with AI (≥ 20 years) diagnosed at our hospital were enrolled and divided into two groups according to the cause of AI (malignancy group, n = 26; other diseases group, n = 28). The patients' clinical characteristics were retrospectively evaluated. Patients in the malignancy group were significantly older than those in the other diseases group (p < 0.001). The cutoff value for age as a factor associated with AI due to malignancy was 64 years (area under the curve: 0.78, 95% confidence interval [CI]: 0.65-0.90). The frequency of chronic symptoms (> 14 days) in AI due to malignancy was significantly higher than the frequencies of acute (≤ 4 days) and subacute (4-14 days) symptoms (p = 0.010 and p = 0.027, respectively). The colonic type of AI was significantly more common than the small intestinal and ileocecal types in the malignancy group (both p < 0.001). Multivariate analysis showed that age of ≥ 64 years, chronic symptoms, and the colonic type were independently associated with AI due to malignancy (adjusted odds ratio [OR] 16.00, 95% CI 1.23-208.00; adjusted OR 32.70, 95% CI 1.50-712.00; adjusted OR 31.20, 95% CI 2.68-363.00, respectively). Advanced age (≥ 64 years), chronic symptoms, and AI in the colon are characteristics of AI due to malignancy.

Balloon-assisted enteroscopy in the management of adult small-bowel intussusception: a comparative analysis of with and without double-balloon enteroscopy.

Adult small-bowel intussusception (ASI) is a rare condition with pathological etiologies in most patients. Previously, surgical intervention was the primary treatment modality; however, the introduction of balloon-assisted enteroscopy (BAE) has allowed preoperative BAE in some cases to confirm the leading point, thereby guiding management and reducing surgical need. In this study, we investigated whether the introduction of BAE has altered the diagnostic and therapeutic strategies for ASI by retrospectively analyzing and comparing the clinicopathological features of patients before and after its introduction. Fifty-three patients with ASI, initially diagnosed via abdominal computed tomography scanning at Korea University Guro Hospital from 2000 to 2023, were included in our study. Patients were grouped based on double-balloon enteroscopy (DBE) usage, and clinicopathological outcomes were compared retrospectively. Of the 53 patients, 38 (71.7%) had enteroenteric-type intussusception and 15 (28.3%) had enterocolic-type intussusception. Among the patients with enteroenteric-type intussusception, 15.8% had a malignant cause, whereas in the enterocolic type, 60% had a malignant cause (p = 0.001). Of 38 patients with enteroenteric ASI, 15 (39.5%) underwent preoperative DBE. The surgical resection rate was significantly lower in the DBE group (40%) than in the non-DBE group (73.9%) (p = 0.037). Pathological diagnoses of patients who underwent surgical resection without preoperative DBE revealed 17.6% malignancies and 82.4% benign causes, including idiopathic intussusception (four cases) and Peutz-Jeghers syndrome (two cases). No morbidity, mortality, or recurrence was observed. Preoperative BAE is a valuable diagnostic and therapeutic modality for ASI, particularly in cases of low-grade small-bowel obstruction, reducing surgical resection rates in most ASI cases. The introduction of the BAE has significantly improved ASI management, achieving high successful reduction rates and few surgical interventions. BAE should be considered a first-line diagnostic and therapeutic tool for ASI management.

Meckel's Diverticulum-Induced Intussusception Coinciding with Diabetes Mellitus in a Young Adult Male

Introduction: Intussusception in adults, especially when caused by Meckel's Diverticulum, is a rare occurrence, often presenting with nonspecific symptoms such as abdominal pain and nausea, making it challenging to diagnose. When concurrent with conditions like diabetes mellitus, the situation need particular care. Case Illustration: A 27-year-old male with a medical history of diabetes presented with severe right abdominal pain, nausea, and a reduced appetite. Initial symptomatic treatment did not alleviate the condition. Subsequent CT scans revealed an ileo-ileal intussusception triggered by Meckel's Diverticulum and partial high obstruction ileus, leading to surgical intervention. Discussion: Ileo-ileal resection (end to end anastomosis) and adhesiolysis surgery were successfully performed, followed by vigilant postoperative monitoring for complications, effective pain management, maintenance of drain patency, and careful glucose level monitoring. The patient's significant postoperative improvement underscores the importance of early diagnosis and timely surgical intervention in managing Meckel's Diverticulum-induced intussusception in adults. Conclusion: The clinical course also highlighted the importance of tailoring postoperative care considering the patient's comorbidities, in this case, diabetes mellitus. This case served as a reminder for clinicians to consider Meckel's Diverticulum as a potential cause of intussusception in adults presenting with abdominal pain.