Colonic Intussusception Research Articles

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.

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

AbstractAngiolipomas 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.

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.

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

Colonic lipomas are a benign tumor that can present in multiple ways, including; incidentally, abdominal pain, change in bowel habit, bleeding, intestinal obstruction and intussusception. We present the case of a 48-year-old gentlemen who presented to the emergency department with a 3 day history of abdominal pain and was found to have a 5 cm intramural ischemic pedunculated colonic lipoma causing intussusception and large bowel obstruction. He received initial management with emergency laparoscopic exploration, reduction of intussusception, colotomy and lipoma excision. He made a full recovery. The current approaches to management of colonic lipomas are conservative, endoscopic or surgical. This case highlights the potential consequences of untreated colonic lipomas. In our review of the literature, we highlight that there is a lack of clear consensus on appropriate management of these patients.

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

A Rare Case of Sigmoid Intussusception due to Sigmoid Diverticula in a Patient with Concomitant Extensive Small Bowel Diverticula

Small intestinal diverticula is a rare occurrence, and their surgical management remains controversial due to the lack of a recognized classification system. Complications such as perforation and obstruction are treated surgically. Their etiology remains nebulous but theories such as damage to the Auerbach’s nerve plexus have been advanced as a possible cause. The concomitant presence of a sigmoid intussusception due to diverticular disease in the same patient is truly a rare occurrence. The vast majority of colonic intussusception is due to malignancy and a benign etiology remains elusive. The reported cases of benign causes include a lipoma and benign lymphadenopathy. We believe this to be the first such case report of a colonic diverticulum causing an intussusception. Despite an exploratory laparotomy of less than sixty minutes, the patient demised in the intensive care unit following an occipital lobe stroke. We believe this case of sigmoid intussusception with concomitant small intestinal diverticula to be the first such case report of its kind in English-language scientific publications.

Adult colocolic intussusception and lower gastrointestinal hemorrhage due to a colonic lipoma

Colonic intussusception is a rare complication of colonic lipoma. This study presents an unusualcase of a symptomatic lipoma of the transverse colon, causing colonic intussusception andlower gastrointestinal hemorrhage. A 53 year-old female was admitted to Bushenge ProvincialHospital, Rwanda, with episodes of intermittent pain, vomiting, and bloody mucoid stool. Physicalexamination revealed a distended abdomen, tenderness and bloody mucous from the rectum.Ultrasonography revealed a target sign suggestive of intussusception. The patient underwentsegmental resection of the transverse colon, and histopathology analysis of the specimen revealeda lipoma. The patient was followed up for a year and 8 months after the resection and remainedhealthy. This study serves as a guide for the management of complicated colonic lipoma, especiallyin resource-limited settings.

Adult sigmoid intussusception as a rare presentation of advanced adenocarcinoma: a case report

Adult bowel intussusception is a rare clinical entity resulting in 1-5% of intestinal obstructions. It occurs more often in the small intestine and it’s secondary to a pathologic condition in 90% of cases. Its clinical picture can be unspecific, and the diagnosis is often made intraoperatively. We describe an uncommon clinical presentation of this rare clinical entity. A 69-year-old female presented in our emergency room with severe abdominal pain and rectorrhagia. The abdomen computed tomography scan revealed a colonic intussusception and a mass suggestive of a malignancy, as confirmed by rectosigmoidoscopy. The patient underwent the Hartmann procedure. A histopathological examination revealed an advanced colorectal adenocarcinoma as the lead point of the intussusception. Adult sigmoid intussusception is a rare cause of bowel obstruction, and it is often cancer-related. Symptoms can be nonspecific, and diagnosis is best made by CT imaging and endoscopic investigations which allow for planning surgery.

A Colic Adenocarcinoma as the Primary Cause of Colo-Colic Intussusception: A Rare Case of Obstruction

This article discusses the case of a 70-year-old woman who presented with abdominal pain and vomiting, and was diagnosed with colonic-colonic intussusception caused by a tumor. Colonic intussusception is a rare cause of acute abdomen in adults, and malignant tumors are the most frequent cause of colonic intussusception. The article highlights the importance of imaging, specifically abdominal CT scans, in diagnosing and managing this condition. The CT scan can confirm the site of intussusception and specify the severity signs, and it is more specific than ultrasound and endoscopy. The article also describes the different intussusception patterns seen on CT scans and their significance. Early diagnosis is important in preventing complications such as infarction and perforation. The authors suggest that colonic intussusception may be the result of infiltration of the colonic wall musculature by the malignant tumor despite the colon being devoid of peristaltic activity. Overall, the article emphasizes the importance of a combination of clinical and radiologic data in diagnosing and managing colonic intussusception caused by tumors.

Giant lipoma of the colon presenting as a case of adult intussusception: A case series

Introduction and importanceLipoma of the intestine is one of the uncommon benign tumors of the alimentary tract first reported by Bauer in 1957. The peak incidence is usually seen between 50 and 60 years of age and more commonly in females. They are usually either asymptomatic or mildly symptomatic. The occurrence of symptoms is mostly related to the diameter of the lesion. Presentation of caseWe present a single center consecutive case of three patients who had giant colonic lipomas presented with colonic intussusception. Two of the cases presented for the first time with an emergency condition: acute intestinal obstruction. The mode of presentation, diagnosis, and management outcome of colonic lipoma was assessed. DiscussionSymptomatic lipoma may present with non-specific abdominal pain, change in bowel habits, intussusception, and hemorrhage. The clinical diagnosis is usually challenging, given the non-specificity of symptoms of the disease. Computed tomography is considered to be a diagnostic modality of choice in recognizing the presence of lipoma. However, a definitive diagnosis of lipoma is usually obtained after a histopathologic examination of the resected specimen. The management of colonic lipoma depends on the size of the lesion and the presence or absence of symptoms. ConclusionColonic lipoma is a rare benign tumor that occurs in the elderly, frequently misdiagnosed as a malignant tumor. Despite the rarity of the disease, lipoma should be considered in the differential diagnosis of large bowel tumors and adult intussusception.

PRIMARY EOSINOPHILIC COLITIS WITH CONCOMITANT NEWLY DIAGNOSED INFLAMMATORY BOWEL DISEASE – A DIAGNOSITIC CONUNDRUM

Eosinophilic colitis (EC) is a rare primary condition characterized by eosinophilic infiltration of the colon in the absence of secondary causes. Affecting only 0.003% of people in the United States, clinical manifestations of the disease can range from abdominal pain, bloody stools, and diarrhea to colonic obstruction, intussusception, volvulus, and perforation. The diagnosis is made upon histopathological analysis of colonic biopsies with the inflammatory infiltrate consisting predominantly or exclusively of eosinophils with focal collections greater than 100 per high-power field (hpf). Unlike inflammatory bowel disease (IBD), granulomas, crypt architectural distortion, pseudopyloric metaplasia, and fibrosis are not usually present with EC, but differentiating between the two conditions has proven to be difficult over the decades.

COMPLETE RECTAL PROLAPSE WITH CONCOMITANT RECTO-SIGMOIDOANAL INTUSSUSCEPTION - A RARE CASE REPORT

Intussusception is more common in the pediatric age group and very rare in adults. The presentation, etiology and treatment of adult intussusception is different from that in pediatric age group. Adult colonic Intussusceptions account for only 5% of all cases, out of which only 1% present as obstruction. Often the diagnosis in adults is delayed due to vague, chronic and non-specic symptoms that are either ignored or treated symptomatically. Rectal prolapse is more common in geriatric age group compared to younger population. Colonic intussusception can be associated with a rectal prolapse. In children the symptoms of intussusception include palpable abdominal mass, fresh blood in stools and colicky abdominal pain. However, in adults, symptoms consist of bloody stool, constipation or symptoms suggestive of malignancy such as weight loss, altered bowel habits and loss of appetite. We present a case of a complete rectal prolapse with strangulated rectosigmoid intussusception for which sigmoid resection was done with reduction of rectal prolapse, rectosigmoid anastomosis, mesh rectopexy and diverting transverse colostomy