Ileocolic Intussusception Research Articles

Intussusception Presenting as Rectal Prolapse

Intussusception is the invagination of a segment of the intestine into the lumen of the distal or proximal segment. It is one of the commonest causes of intestinal obstruction in the toddlers. Ileo-colic intussusception is the most common type. At times the inussusceptum may protrude through the anal canal and mimic a rectal prolapse. The diagnosis may be delayed in such cases leading to increase morbidity as well as mortality. Therefore, a high index of suspicion is required in such cases. In this case where a colo-colic intussusception presented like rectal prolapse. Emergency surgical reduction was carried out under general anaesthesia and the baby had a smooth recovery.

Mesenteric rent, ileal volvulus and ileocolic intussusception in a 3-year-old large-white dry sow: A postmortem report

This report presents a post-mortem (PM) finding of Large-White dry sow which died from complications associated with mesenteric rent, volvulus and intussusception. Other lesions included hydrothorax, ascites, and engorged mesenteric blood vessels, pale and enlarged liver. Helminthological and protozoological examinations of the intestinal samples were negative. Diagnosis of mesenteric rent, ileal volvulus and intussusception was reached. The diagnosis was attributable to the risk factors which include fight, excessive amounts of dry whey concentrate coupled with poor hygiene in the feeding and management system. Familiarizing swine farmers with the symptoms of bowel obstruction and provision of diagnostic facilities in commercial piggery farms will help in facilitating diagnosis and prompt action to prevent mortality and minimize economic loss.
 Keywords: Intussusception, Mesenteric rent, Sow, Volvulus, Whey

Intussusception in Adults: A Retrospective Review from a Single Institution

PurposeIntussusception is uncommon in adults and often manifests as nonspecific symptoms. Owing to its low incidence and the lack of knowledge on the symptoms, causes, and treatment of adult intussusception (AI), many surgeons may have limited experience in the diagnosis and treatment of intussusception. This study aimed to describe the experience of AI and discuss its clinical presentation, etiology, and management.Material and MethodsI retrospectively reviewed patients aged 19 years and older who were diagnosed with intussusception at a single institution between March 2010 and December 2019.ResultsAmong 28 patients who were finally analyzed, abdominal pain was the most commonly observed symptom. Ileocolic and ileoileal intussusceptions were the most common locations, and a lead point was observed in 19 cases (68%), of which malignancy was observed in six (21%). Bowel resection was performed in 27 cases. According to the pathological findings of the tissue from the resected section, nine and three cases of small bowel intussusception (SBI) were benign and malignant, respectively, whereas 13 and three cases of colonic intussusception (CI) were benign and malignant, respectively. On comparing SBI and CI, it was observed that most variables did not significantly differ, except for the duration of symptoms.ConclusionSBI had a higher lead point than CI. The rate of malignancy in CI cases in this study was lower than that reported in other studies. En-bloc resection can be considered the first option for the treatment of AI.

Laparoscopic Management of Caecal Lipoma Presenting with Ileocolic Intussusception

Laparoscopic Management of Caecal Lipoma Presenting with Ileocolic Intussusception

Shear wave elastography evaluation in predicting the success of ultrasound-guided saline enema hydrostatic reduction technique in ileocolic intussusception.

Intussusception is the invagination of the proximal intestinal segment into the distal portion. Reduction procedures with fluid or air have been used as the primary treatment of choice in clinically stable children. To evaluate the role of intestinal wall elasticity measurements by shear wave elastography (SWE) to predict the success of ultrasound-guided saline enema (USGSE) reduction. USGSE was performed, if not contraindicated otherwise, after the diagnosis of ileocecal intussusception via the ultrasound (US). The length and diameter of the intussusception and the median stiffness of the intestine were measured before USGSE. Seventeen children were diagnosed with ileocolic intussusception via grayscale US assessment. Two children whose SWE images became artifacts due to inadaptability were excluded from the study. Thus, the study involved 15 patients (9 boys, 6 girls; age range = 11-48 months). There was no statistically significant association between age and median stiffness measurement in kilopascal (kPa). (P > 0.05). A moderate positive correlation was observed between the median stiffness measurement (kPa) and the length of intussusception (r = 0.547; P = 0.035). There was no statistically significant relationship between median stiffness measurement (kPa) and short-axis diameter of intussusception (P > 0.05). Stiffness assessment of the intestinal wall in ileocolic intussusception during the US examination, which is the gold standard in the intussusception assessment, can be used as a new criterion for predicting the performance of the USGSE technique and might be useful in making decisions regarding the clinical management of ileocolic intussusception.

A Rare Case of Low-grade Appendicular Mucinous Neoplasm Presenting as Ileocolic Intussusception

Appendiceal mucinous neoplasms are rare and account for just 0.6 percent of gastrointestinal malignancies and approximately 0.7-1 percent of appendicectomy specimens. Most of the appendicular malignancies are detected incidentally. We, herein, report images of a case of a 76 years old male patient who presented with dull pain in the lower abdomen and a palpable lump in the right lower abdomen. A contrast enhanced computed tomography scan of the abdomen revealed an ileo-colic intussusception. He underwent a laparoscopic quarter colectomy with ileo-colic anastomosis followed by an uneventful post-operative recovery. The histopathology report revealed a low grade appendiceal mucinous neoplasm with clear resecton margins.

Prolapsed ileocolic intussusception in an adult : A bizarre presentation leading to delayed diagnosis in a low resource setting

Background: Intussusception is the telescoping of one part of the intestine into the lumen of the adjoining part, which occurs more in the ileocaecal part of the intestine. It is the most common cause of intestinal obstruction in children younger than 3years of age. Occurrence is rare in adult, with prolapsed intussusceptions even rarer and occuring more in association with an underlying predisposing intestinal abnormality.Case Report: A 19year old boy presented with 6months history of recurrent non-specific, occasionally dull aching abdominal pain, progressive weight loss and a 4hour history of anal protrusion. He had presented multiple times to a peripheral hospital where the definitive diagnosis was missed. He was evaluated for ileocolic intussusception and he had exploratory laparotomy and right hemi colectomy done.Conclusion: Intussusceptions are rare outside childhood, however there should be a high index of suspicion of intussusception in adult with nonspecific abdominal symptoms who has not responded to conventional conservative therapy.
 Keywords: intussusception, ileocolic, tubular adenoma, adult intussusception

Ileal lipoma causing ileo-ileocolic intussusception

Intussusception is one of the most common pediatric surgical emergencies. While most cases are idiopathic, some are caused by a pathologic lead point (PLP). Lipoma is a rare PLP in intussusception, particularly among pediatric patients. We present a case of an otherwise healthy three year old boy, who presented with three days of abdominal pain, vomiting, and worsening abdominal distension. An ileocolic intussusception was diagnosed on ultrasound and underwent an unsuccessful air enema reduction. At exploratory laparotomy, he had an irreducible intussusception with a lead point requiring a small bowel resection. The pathology report demonstrated a 1.4cm submucosal lipoma as the likely lead point. His post-operative care was uneventful, and he was discharged to home on post-operative day four, and is doing well.

Clinical Characteristics According to Age and Duration of Symptoms to Be Considered for Rapid Diagnosis of Pediatric Intussusception.

Purpose: The purpose of this study was to evaluate whether clinical findings in children with ileocolic intussusception differ based on age and duration of symptoms and to assess the clinical characteristics of diagnosed and undiagnosed patients to determine which symptoms make diagnosis more difficult.Methods: We reviewed 536 medical records of <15-year-old children diagnosed with ileocolic intussusception between 2008 and 2019. We divided the children into three categories according to age (<1 year, 1–2 years, and ≥2 years). The children were also divided into two groups based on whether symptoms lasted for more or <6 h. Diagnosed and undiagnosed children were assessed separately during for the initial evaluation.Results: Following analysis of the three age groups, bloody stool, post-enema bloody stool, diarrhea, vomiting, poor oral intake, and lethargy were more frequent in children aged <1 year. In children aged ≥2 years, non-specific abdominal pain was more frequent and the undiagnosed rate was higher. Following analysis of the duration of symptoms, paroxysmal pain was significantly more frequent in the early group (<6 h), and bloody stool and fever were significantly more frequent in the late group (≥6 h). Nonspecific abdominal pain was more frequent and the door-to-diagnosis time was significantly longer in the undiagnosed group than in the diagnosed group.Conclusions: Clinical findings of ileocolic intussusception vary depending on the age and duration of symptoms. Younger children with paroxysmal pain, vomiting, bloody stool, poor oral intake, or lethargy should be suspected of having intussusception. In older children, non-specific abdominal pain without bloody stool may be a symptom of intussusception. Glycerin enema is helpful in diagnosing intussusception in children with no typical symptoms.

Intestinal Intussusception as Crohn’s Disease Debut

Intussusception is a rare cause of intestinal obstruction in adults, occurring only in 5% of cases. Clinical case: a 22-year-old male patient with intestinal obstruction secondary to ileocolic intussusception as the onset of inflammatory bowel disease, who underwent en bloc resection of the affected segment. Keywords: Intussusception; Crohn’s disease

Ultrasound-guided hydrostatic reduction of ileo-colic intussusception in childhood: first-line management for both primary and recurrent cases

Objective To evaluate the results of ultrasonography-guided hydrostatic reduction in primary and recurrent ileo-colic intussusception in children. Methods The children (<18 years of age) who were managed for ileo-colic intussusception between January 2015 and December 2018 were evaluated retrospectively. Age, gender, presenting complaints, length of the intussuscepted segment, presence of lead point, treatment modalities, recurrence rates and duration of recurrence were evaluated. Results 108 patients with ileo-colic intussusception were enrolled in the study; 59 were male and 49 were female with a mean age of 2.04 ± 1.71 years. Two patients underwent immediate surgery without any attempt of hydrostatic reduction. Nineteen patients (18%) were managed by conservative measures initially. Seventeen (89.5%) of them have recovered with expectant management and two patients required hydrostatic enema reduction during follow-up. In total, 89 patients underwent hydrostatic reduction; 48 were male and 41were female with a mean age of 1.9 ± 1.65 years. Twelve patients (13.5%) received surgery after failed hydrostatic reduction. In the patients with successful hydrostatic reduction, one more episode of intussusception is seen in 10 patients (13%) and 2 additional episodes in 2 (2.6%). Seven patients with relapse were male and 5 were female with a mean age of 1.16 ± 1.64 years. The median duration of the first relapse episode was 67.5 days (range 18–110 days). The ultrasound-guided hydrostatic reduction was also successful in patients with recurrence. Conclusion Ultrasound-guided hydrostatic reduction is a non-invasive treatment of ileo-colic intussusception with high success rates in childhood. It can be performed safely in both initial and relapse episodes of intussusception.

Factors Associated with Failure of Pneumatic Reduction in Children with Ileocolic Intussusception.

Intussusception is one of the most common causes of intestinal obstruction in children. Pneumatic reduction is the treatment of choice and has a high success rate. The most common cause of pneumatic reduction failure is the presence of a pathological leading point. We aimed to identify other factors that can lead to pneumatic reduction failure in children with ileocolic intussusception. This was a retrospective study conducted in two centers. Data were collected from January 2013 to December 2014. A total of 156 patients were diagnosed with intussusception and underwent pneumatic reduction, with the exception of one patient with peritonitis. We included patients with ileocolic-type intussusception without apparent pathological leading points. Logistic regression analysis of clinical parameters was performed to identify factors associated with pneumatic reduction failure. Of 156 patients diagnosed with intussusception in both hospitals, 145 were enrolled in the study. The overall efficacy of pneumatic reduction was 85.7%, and surgical reduction was performed in 21 patients. Univariate analysis showed that a high segmented neutrophil count, low hemoglobin level, high body temperature, and higher weight percentile were associated with pneumatic reduction failure. Multivariate analysis showed that a high segmented neutrophil count, low hemoglobin level, and higher weight percentile were significantly associated with pneumatic reduction failure. Pneumatic reduction is safe and effective as a first-line treatment for pediatric intussusception. However, a high segmented neutrophil count, low hemoglobin level, and higher weight percentile are associated with the failure of this treatment.

Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children\u2019s hospital

BackgroundItaly was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children’s hospital, composed by two different pediatric centers, one located in Rome’s city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED’s) and urgent hospitalizations compared to prepandemic period.MethodsThe study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics.ResultsThe reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access.ConclusionsIn the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn’t demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.

L’invaginazione ileocolica

Ileo-colic intussusception is a major cause of intestinal obstruction in early childhood. Diagnosis of this condition might be hampered by variability in clinical presentation. Indeed, the so-called “classic” symptoms, namely abdominal pain, red currant jelly stool, vomiting and palpable mass, may not be present. Nevertheless, prompt diagnosis and treatment are critical to prevent bowel perforation or necrosis and peritonitis. Pneumatic reduction of intussusception with an air enema is the usual treatment. The aim of this study is to highlight the main clinical features of ileo-colic intussusception and its management.

Gastrogastric Intussusception Secondary to Gastrointestinal Stromal Tumour: a Case Report

Intussusception is rare in adults and accounts for only 1–5% of cases of bowel obstruction; in the majority of cases, it is secondary to a lead point and most commonly occurs as ileocolic intussusception; gastrogastric intussusception is extremely rare. The case of a 60-year-old lady with gastrogastric intussusception secondary to a gastric gastrointestinal tumour is reported and the relevant literature briefly reviewed.

A rare case of adult ileo-colic intussusception: Hamartomatous polyp as a lead point with concurrent appendiceal neurofibroma in Neurofibromatosis Type 1

Intussusception is a rare cause of adult intestinal obstruction and unlike in children, adult intussusception is commonly caused by a lead point, requiring surgical intervention in most cases. Hamartomatous polyp is a non-neoplastic growth of tissue containing mature cells, distributed in an abnormal manner. It is often associated with intestinal polyposis syndromes such as Peutz-Jeghers syndrome and Juvenile polyposis. In the current case, we report an extremely rare case of ileo-colic intussusception secondary to a lead point of an isolated ileal hamartomatous polyp in an elderly gentleman with Neurofibromatosis type-1. Patient was successfully treated with ileo-colic resection involving the intussuscepted segment of bowel. There was an incidental finding of a nodule in the appendix and the histology confirmed this as a neurofibroma. Post-operative recovery of the patient was unremarkable.

Ileocolic Intussusception in an Infant with Ileal Duplication Cyst as a Lead Point- A Case Report

Gastrointestinal duplication cysts are uncommon congenital malformations, with small intestine being the most common site, followed by colon and stomach. It can have variable presentations such as intestinal obstruction, bleeding, palpable mass, or rarely volvulus. Here, the authors report a case of intussusception in a two-year-old child, presented with complaints of bilious vomiting and abdominal distension for three days with X-ray features suggestive of bowel obstruction. Ultrasonography revealed intussusception with ileal duplication cyst as the lead point, which was confirmed on exploratory laparotomy. In a paediatric patient, enteric duplication cyst should be included in the differential diagnosis of a cystic lesion as the lead point in intussusception.

Intussusception in Adult due to Lipomatous Polyp - An Uncommon Case Report

Intussusception, invagination of a segment of the gut into an adjacent one, is a relatively common cause of the intestinal obstruction in children but a very rare and uncommon clinical entity in the adults accounting to 1% and near about 65% of these are caused by malignant lead point. The Lipomatous polyp accounts for 4% of all benign tumors of the gut. In most of the cases, these are seen particularly in large intestine, usually sub mucosal and around ileocecal valve. These are mostly and very often asymptomatic. Mrs. Rahima Begum aged 65 years, previously was a healthy Bangladeshi housewife, with the history of recurrent abdominal colic of moderate intensity for the last 6 months, associated with the appearance of mass in the right lower quadrant with features of sub-acute intestinal obstruction got admitted into the Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, Bangladesh. The required and most relevant investigations revealed the Ileocolic intussusception and underwent the right hemicolectomy. Postoperative recovery of the patient was uneventful excepting the hypertension only. Histopathology investigations revealed lipomatous polyp arising from the Ileocecal junction. This study reports intussuception in the adult due to lipomatous polyp, a very rare case presenting with sub acute intestinal obstruction.&#x0D; Bangladesh Journal of Medical Science Vol.20(1) 2021 p.204-207

A 9-Month-Old Boy with a Recurrent Ileocolic Intussusception Caused by Diffuse Large B Cell Lymphoma: A Case Report

A 9-Month-Old Boy with a Recurrent Ileocolic Intussusception Caused by Diffuse Large B Cell Lymphoma: A Case Report

Factors Associated with Success of Sonographically Guided Hydrostatic Reduction of Ileocolic Intussusception in Children

Factors Associated with Success of Sonographically Guided Hydrostatic Reduction of Ileocolic Intussusception in Children