Colonic Intussusception Research Articles

A Woman with Abdominal Pain

Case Presentation: A 28-year-old woman with a history of cocaine and opioid use disorder presented to the emergency department with abdominal pain, nausea, and vomiting for two days. She’d had irregular bowel movements with constipation for quite some time. Physical exam was notable for diffuse peritonitis and melena on digital rectal exam. Patient had a witnessed episode of hematochezia. Computed tomography of the abdomen and pelvis with intravenous contrast demonstrated sigmoid colon intussusception, and the patient underwent emergent surgery for definitive treatment. Specimen was sent to surgical pathology and revealed no lead point. Discussion: While sigmoid intussusception is not a rare finding, it is exceedingly rare in young adult patients who do not have a pathologic lead point. Lead points are areas of inflammation, lesions, or masses that snag the bowel and initiate the process of telescoping that ultimately results in an intussusception. This patient was not found to have such a lead point on gross examination during surgery or on extensive specimen examination in the pathology lab. Instead, her sigmoid intussusception is hypothesized to be secondary to decreased gut motility in the setting of chronic opioid use disorder.

Sigmoid cancer intussusception mimicking strangulated rectal prolapse.

This case report highlights a rare instance of colonic intussusception mimicking strangulated rectal prolapse in a woman. Initially misdiagnosed with strangulated rectal prolapse, the patient presented with a painful, irreducible rectal mass. Unexpected clinical signs led to further imaging, revealing colonic intussusception with a malignant mass. This underscores the diagnostic challenges of overlapping symptoms and the necessity of thorough examinations to detect subtle anatomical differences. An emergency CT scan showed a prolapsed sigmoid colon prompting a total mesorectal excision and end colostomy due to poor sphincter tone, with positive postoperative results. This case emphasises maintaining a high suspicion for alternative diagnoses in ambiguous rectal masses and advocates for a multidisciplinary approach using advanced imaging when examinations are atypical. An accurate preoperative diagnosis and tailored surgical strategy are crucial for optimal outcomes, highlighting the importance of individualised management in complex colorectal cases.

Lipoma of the cecum complicated by intussusception (clinical case)

AIM: to present clinical case of complicated cecal lipoma.PATIENTS AND METHODS: patient K., 62 years old, with one and a half years with a diagnosis of ascending colon lipoma with bloating, abdominal pain, was hospitalized in the coloproctology unit in an emergency with a diagnosis of partial intestinal obstruction. When analyzing the data of RCT of OBP, there was a suspicion of intussusception of the right colon, and a decision was made on surgical treatment. Laparoscopic right hemicolectomy was done.RESULTS: colon lipomas are benign tumors that are asymptomatic, are mostly random findings during video colonoscopy, and do not require treatment. But an increase in the size of the tumor can lead to the development of complications for which surgical treatment is used.CONCLUSION: the authors present a clinical case of a 62-year — old female patient with cecal lipoma complicated by colon intussusception, which required surgical correction.

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.

COLOCOLIC INTUSSUSCEPTION ASSOCIATED WITH INTESTINAL LEIOMYOSARCOMA IN A DOG

A 7-year-old neutered Standard Poodle was admitted due to chronic bloody diarrhea. The owner reported that the symptoms began approximately 5 months prior, including diarrhea, hyporexia, tenesmus, and weight loss. After performing a clinical examination, abdominal ultrasonography, plain radiography, and contrast rectal radiography, a diagnosis of colocolonic intussusception was made and confirmed by exploratory laparotomy. The procedure revealed that the cause of the obstruction and trigger of the intussusception was a mass that occluded more than 80% of the intestinal lumen. Histopathological analysis identified the mass as an intestinal leiomyosarcoma. This case represents one of the few published cases of colonic intussusception of neoplastic origin in a dog and highlights the utility of abdominal ultrasound and rectal contrast radiography for a timely diagnosis. Additionally, the complications associated with the therapeutic approach are emphasized.

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

Retrograde Colonic Intussusception After Colonoscopy without Organic Pathology: A Case Report

Patient: Female, 74-year-oldFinal Diagnosis: Retrograde intussusception of the sigmoid colonSymptoms: Abdominal distension • constipationClinical Procedure: —Specialty: SurgeryObjective:Rare diseaseBackground:Adult colonic intussusceptions are relatively rare and are mostly caused by organic structures that serve as lead points. However, the pathogenesis of adult intussusception is not fully understood, and no cases of retrograde colonic intussusception without pathological abnormalities or associations with colonoscopy have been reported.Case Report:A 74-year-old woman presented with abdominal distension and constipation. Abdominal computed tomography (CT) revealed marked dilatation of the right and sigmoid colon, initially suggesting volvulus of the sigmoid colon. Observation of the left colon revealed no abnormal findings on the colonoscopy. Due to the persistence of abdominal symptoms from right colon dilatation, another colonoscopy was performed, and a transanal drainage tube was inserted into the transverse colon. Enterography showed a steep contrast interruption in the descending colon, which was missed at this time. The patient’s abdominal pain worsened 3 days after removal of the drainage tube. Retrograde intussusception of the sigmoid colon was discovered on abdominal CT, and a laparoscopic left hemicolectomy was performed. Pathological examination revealed multiple ulcers in the superimposed area, but no abnormal organic findings that could be considered as a lead point were found. In this case, the stretching technique and/or shear stress on the sigmoid colon by a second colonoscopy may have contributed to the development of this condition.Conclusions:This is the first report of colonoscopy-associated retrograde colonic intussusception without organic abnormalities. Although much is unknown about the pathogenesis in this case, it may provide new insights into the pathogenesis of intussusception.

S3003 A Rare Case of Adult Colonic Intussusception Caused by Colon Cancer

S3003 A Rare Case of Adult Colonic Intussusception Caused by Colon Cancer

Intestinal intussusception, colorectal cancer and intestinal endometriosis as a combined cause of intestinal obstruction: a case study

The paper describes a unique clinical case involving a patient with two tumours of mesenchymal and epithelial origin, along with ectopic endometriosis located within the cecum. This combination of pathologies resulted in colonic intussusception and subsequent colon-small intestine obstruction due to a cecal lipoma, compounded by colorectal cancer in the same area with local endometriosis foci. The surgical intervention involved laparoscopic resection of the terminal ileum, cecum, ascending, transverse, and descending colon, along with D2 lymphadenectomy and laparoscopically assisted ileosigmoid anastomosis. The patient was discharged in satisfactory condition on the 7th day post-surgery. This clinical observation garnered significant attention due to its atypical presentation of a rare complication, initially leading to a misdiagnosis and necessitating extensive intestinal resection for cancer under urgent circumstances with adequate lymph node dissection. Furthermore, the favourable treatment outcome despite the long-term presence of intussusception for at least one month underscores the noteworthy aspect of this case.

Single-port laparoscopic surgery for cecum cancer with intussusception: a case report

BackgroundMost 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 presentationAn 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.ConclusionsWith 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.

Idiopathic Ileocolonic Intussusception in the Elderly: Case Report and Literature Review

Background: Adult intussusception is rare, in sharp contrast to childhood intussusception. It’s often considered a distinct disease entity from the paediatric intussusception because of dissimilarities in the aetiology, clinical presentation and management options. Operative treatment is mandatory for the management of colonic intussusception in the adult patient as many cases are associated with bowel tumours. Case presentation: An 86-year-old male retired civil servant presented with clinical and radiological features of ileocolonic intussusception. He had extended right hemicolectomy. The histology revealed an idiopathic ileocolic intussusception without an associated bowel tumour. He made an uneventful recovery and was discharged on the 8th day after surgery. Conclusion: Adult intussusception is not only rarer than the childhood disease, but requires mandatory surgical operation for treatment. This case involving an elderly patient in his 9th decade of life is reported to highlight the deviation from the usual pattern of presentation of this disease in an adult patient.

An unusual cause of adult transverse colonic intussusception with obstruction: Multiple large submucosal lipomas in a 50-year-old male

Intussusception is a gastrointestinal condition that predominantly affects the pediatric population. Although uncommon, it can occur in adults and is typically due to a pathological lead point that causes telescoping of the intestine during peristalsis. In this case, a 50-year-old male presents with abdominal pain, distension, diarrhea, and unintentional weight loss, which was revealed to be caused by intussusception that originated at a cluster of submucosal lipomas in the transverse colon. This patient had recently immigrated to the U.S. from Africa, and had missed his colorectal screening, which is recommended at age 45 for every person. It is crucial to accurately screen for, diagnose, and surgically treat this condition to prevent downstream complications such as bowel infarction or perforation.

Idiopathic Ileocolonic Intussusception in the Elderly: Case Report and Literature Review

Background: Adult intussusception is rare, in sharp contrast to childhood intussusception. It’s often considered a distinct disease entity from the paediatric intussusception because of dissimilarities in the aetiology, clinical presentation and management options. Operative treatment is mandatory for the management of colonic intussusception in the adult patient as many cases are associated with bowel tumours. Case presentation: An 86-year-old male retired civil servant presented with clinical and radiological features of ileocolonic intussusception. He had extended right hemicolectomy. The histology revealed an idiopathic ileocolic intussusception without an associated bowel tumour. He made an uneventful recovery and was discharged on the 8th day after surgery. Conclusion: Adult intussusception is not only rarer than the childhood disease, but requires mandatory surgical operation for treatment. This case involving an elderly patient in his 9th decade of life is reported to highlight the deviation from the usual pattern of presentation of this disease in an adult patient.

Clinical Presentations, MDCT Features, and Treatment of Three Types of Adult Intussusceptions Based on the Location.

This study aimed to explore the similarities and differences in clinical presentations, multidetector computed tomographic (MDCT) features, and treatment of three types of adult intussusceptions based on location. We retrospectively reviewed 184 adult patients with 192 intussusceptions. Depending on the location, intussusceptions were classified as enteric, ileocolic, and colonic types. The similarities and differences of clinical presentations, MDCT features, and treatment of three types of adult intussusception were compared. Meanwhile, the three types of intussusceptions were further divided into surgical and conservative groups based on the treatment. Uni- and multivariate logistic analyses were used to identify risk factors for intussusception requiring surgery. Enteric and ileocolic intussusceptions were mainly presented with abdominal pain (78.46% and 85.71%). Hematochezia/melena (64.29%) was the main symptom of colonic intussusception. On MDCT, ileocolic intussusceptions were longer in length and had more signs of intestinal necrosis (hypodense layer, fluid collection and no/poor bowel wall enhancement) than enteric and colonic intussusceptions. Moreover, it was found that 93.88% (46/49) of ileocolic intussusception and 98.59% (70/71) of colonic intussusception belonged to the surgical group, whereas only 43.06% (31/72) of enteric intussusception belonged to the surgical group. Intussusception length (OR=1.171, P=0.028) and discernible lead point on MDCT (OR=21.003, P<0.001) were reliable indicators of enteric intussusception requiring surgery. Ileocolic intussusception may be more prone to intestinal necrosis than enteric and colonic intussusceptions, requiring more attention from clinicians. Surgery remains the treatment of choice for most ileocolic and colonic intussusceptions. Less than half of enteric intussusceptions require surgery, and MDCT features are effective in identifying them.

Unusual Case of Colonic Intussusception Caused by Angiolipoma: Case Report and Literature Review

Abstract Angiolipomas are benign tumors composed of adipose tissue commonly found in the subcutaneous tissue with vascular proliferation. It is uncommon to find it in the gastrointestinal tract. This report focuses on an angiolipoma found in the sigmoid colon causing intussusception in a young healthy 26-year-old male. We discuss the presentation, workup and surgical management.

Colonic intussusception from pedunculated colonic lipoma at hepatic flexure: A case report and review of current literature

Colonic intussusception from pedunculated colonic lipoma at hepatic flexure: A case report and review of current literature

Immunoglobulin A Vasculitis With Intussusception in Children.

Immunoglobulin A (IgA) vasculitis with intussusception is acute and severe vasculitis combined with acute abdomen in children. The diagnosis of the disease depends on the results of imaging examinations, and its treatment mainly includes enema and surgery. The literature summarized the detailed diagnosis and treatment data in previous literature reports. We described the clinical manifestations, ultrasonic features, and treatment of patients admitted to a single center and reviewed previous literature regarding cases with detailed clinical data in the PubMed database within the past 20years. The review included 36 patients, including 22 boys and 14 girls. A total of 32 patients were diagnosed using ultrasound (88.9%). The main sites of intussusception were the ileum and ileocolon in 16 (44.4%) and 11 (30.6%) cases, respectively. Thirteen patients (36.1%) were treated with enema, with 6 responding to the treatment. 26 patients (72.2%) underwent surgical treatment. Patients with ileal intussusception were more likely to be treated with surgery than those with colonic intussusception (P < .05). The single-center clinical data of 23 patients showed that there was no significant difference in laboratory test findings between patients with and without surgical treatment (P > .05). Patients with long insertion lengths were more likely to require surgery and resection (P < .05). Ultrasonography is the first-line investigation for diagnosis. The main sites of intussusception were ileum and ileocolon. The length of intubation was related to surgery; treatment is according to the intussusception site. Air enema is not suitable for intussusception of the small intestine.

Sub-Mucosal Lipoma a Rare Cause of Colonic Obstruction Managed Surgically: Case Series and Literature Review

Sub-mucosal lipomas of the colon, as first described by Bauer in 1757 are fatty tumors, rarely greater than 2 cm in size and hence rarely symptomatic. The vast majority of these tumors are subjected to be found incidentally during a colonoscopy, Computed Tomography (CT) scan, surgery, or autopsy and are most often located in the ascending colon near the cecum. Referred to second most common benign tumour of the colon, sub-mucosal colonic lipomas are often difficult to diagnose because of their asymptomatic nature or the intermittent, non-specific nature of patients’ symptoms. In this domain, development of symptoms manifesting as abdominal pain, hemorrhage, diarrhea, or constipation are most commonly encountered with lipomas of size greater than 2 cm. Furthermore, obstruction secondary to colonic intra-luminal narrowing or intussusception is mostly reserved for larger lipomas, most commonly those growing more than 4 cm in size and hence requiring surgical or endoscopic resection. However, as such lesions are more often being exposed nowadays owing to the enhanced utilization of colonoscopy and CT and the fact that complications can prevail, both rises the need of settling well established guidelines advising the management of such polyps, on the road of preventing consequent complications. In this article and in trial of us addressing this rare entity, shedding the light on its importance and further elaborating on its significant consideration in working up bowel obstructive pathologies, we present a literature review of colonic sub-mucosal lipomas, along with our experience in obstructive colonic lipomas, in a retrospective case series constituted of 4 characteristically and demographically studied patients, along with the management after being admitted to our tertiary care center for obstructive symptoms.

The Management of Intussusception: A Systematic Review.

Intussusception (ISN) is adangerous condition where a portion of the intestine slides into an adjacent area of the intestine. This telescoping motion frequently prevents liquids or food from flowing through. Developing management guidelines for ileocolic (IC) intussusception was the aim of this systematic study.Data sources were PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scopus, and Embase databases. Our review investigated English-language articles (from 2010 to 2023) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Overall, there were 15 articles. Surveys and analyses of national databases were the most widely used methods (n=15). The search identified 561 studies; 15 were eligible for inclusion in the analysis. Further understanding of the management of intussusception may help improve evaluation and management in the future. The use of preventive antibiotics does not reduce problems following radiologic reduction. When clinically appropriate, repeated attempts at enema reduction may be made. After the enema reduction of ileocolic intussusception, patients can be safely watched in the emergency room (ER), thereby avoiding hospitalization. Success rates for laparoscopic reduction are high. When it comes to intussusception in children who are hemodynamically stable and do not have a serious illness, there is no need for pre-reduction antibiotics. Prioritizing nonoperative outpatient (OP) therapy is recommended as the primary approach, with the utilization of minimally invasive procedures to avoid the necessity for laparotomy. The management of colonic intussusception involves complete removal in one piece, while enteric intussusception can be addressed through reduction followed by resection. A targeted approach is recommended, recognizing the intermediate forms of intussusception that may exist between the colonic and enteric types. It is essential to note that the prevailing treatment for adult intussusception remains to be surgical intervention.

S3355 Colonic Intussusception: A Rare Syndrome Treated With a Novel Therapeutic Modality

S3355 Colonic Intussusception: A Rare Syndrome Treated With a Novel Therapeutic Modality