Intestinal Intussusception Research Articles

Intussusception of the distal bowel after ileostomy

Postoperative intussusception (POI) in preterm infants is very rare; intussusception at the distal end of the stoma is not seen. A 13-day-old premature infant was referred from peripheral hospital with history of necrotizing enterocolitis(NEC), which after the surgery of enterostomy. No typical symptoms appeared during treatment. Distal intestinal intussusception found during closed enterostomy. The patient recovered well after excision of the intussusception and intestinal anastomosis.

Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report.

BackgroundA leiomyosarcoma of the gastrointestinal tract is extremely rare. We report a case of jejunal leiomyosarcoma with intestinal intussusception at the angle of Treitz that was successfully treated with laparoscopic resection followed by intracorporeal reconstruction using a delta-shaped anastomosis.Case presentationA 54-year-old man was referred to our hospital due to fatigue and loss of appetite. Blood tests showed anemia. Enteroscopy and subsequent enterography using meglumine sodium amidotrizoate showed easily hemorrhagic tumor (10 cm in diameter) in the jejunum just beyond the angle of Treitz. Contrast-enhanced computed tomography revealed jejunojejunal intussusception. Histopathological examination of a biopsy specimen revealed a leiomyosarcoma. Laparoscopic resection of the tumor without reduction of the intussusception was performed. The resected line of the proximal intestine was very close to the ligament of Treitz in the present case. Intracorporeal jejunojejunostomy was completed using a delta-shaped anastomosis, wherein anastomosis was performed between the posterior walls of the proximal and distal jejunums after minimal mobilization around the ligament of Treitz. The patient’s postoperative course was uneventful, and he was discharged at 10 days postoperatively. No recurrence has been observed within 2 years after surgery.ConclusionsWe present a case in which a totally laparoscopic surgery for leiomyosarcoma located at the angle of Treitz with jejunojejunal intussusception was performed successfully.

Efficacy of Abdominal Ultrasonography for Differentiation of Gastrointestinal Diseases in Calves.

Simple SummaryGastrointestinal diseases represent one of the common causes of bovine acute abdomen, such as abdominal distention, abdominal pain, and cessation of defecation. In addition to the observable signs when performing routine auscultation, rectal palpation, and biochemical examinations of ruminal fluid and blood, these clinical observations can provide evidence suggestive of these diseases, but they generally result in an inconclusive diagnosis. Therefore, exploratory laparotomy is often used because it facilitates both diagnosis and therapeutic decisions. For bovines, abdominal ultrasonography is frequently utilized as a convenient imaging modality to assist accurate diagnosis and contribute to subsequent appropriate therapeutic choices for bovine gastrointestinal diseases. According to recent trends in human medicine and small animal practice, technical improvements have led to developments in the diagnostic value of abdominal ultrasonography, including scanning methods and the establishment of valuable diagnostic signs specific to a particular disease, e.g., a target sign for intussusception.This study investigated the clinical efficacy of abdominal ultrasonography for abomasal dilation in three calves, intestinal volvulus in five calves, intussusception in one calf, and internal hernia in one calf. In the abdominal ultrasonograms of the abomasal dilation cases, this disease was commonly characterized by severely extended lumens, including heterogeneously hyperechoic ingesta without intraluminal accumulations of gas. In the animals with intestinal volvulus and intussusception, a to-and-fro flow was observed to be a common ultrasonographic characteristic that led to suspicion of an intestinal obstruction. The use of abdominal ultrasonography for five cases with intestinal volvulus gave no reason to suspect this disease, despite its efficacy in one case, based on an acutely angled narrowing. Although three of five animals with intestinal volvulus had intestinal ruptures, no ultrasonographic evidence could be obtained. When abdominal ultrasonography was used for one case with intussusception, this pathological condition could be strongly suspected, as a “target” sign was observed. This finding supported surgical intervention for this case, followed by treatment with manual reduction, resulting in a favorable outcome. In terms of the differential and definitive diagnosis for various intestinal diseases, abdominal ultrasonography may be poor at providing indicative evidence, but very helpful for confirming intestinal obstruction.

Invaginación intestinal secundaria a tumor de Vanek: una causa infrecuente de obstrucción intestinal en el adulto

Invaginación intestinal secundaria a tumor de Vanek: una causa infrecuente de obstrucción intestinal en el adulto

Intususcepción intestinal en adultos. Un desafío para el cirujano general Reporte de caso

The intestinal intussusception is the invagination of one segment of the bowel into an immediately adjacent segment, associated to an alteration into the wall, the small intestinal is the most associated a benign pathology and large intestinal by malignant pathologies. We present the case of a 30-yearold female patient, who came to the emergency room due to intense abdominal pain of 1 week of evolution and evidence of intestinal occlusion, who underwent emergency laparotomy, where intestinal intussusception was found in the terminal ileum. Generally, the clinical presentation like an intestinal obstruction. Treatment is resection of the affected segment. Key words: Intestinal intussusception; intestinal invagination; intestinal polyp; intestinal obstruction.

Gangliocytic paraganglioma of Meckel diverticulum: An unusual leading point for ileocecal intussusception in an infant

Gangliocytic Paraganglioma is rarely reported in the paediatric age. We describe a case of a 4-month-old infant presenting with an intestinal obstruction from ileocolic intussusception led by Meckel's diverticulum. A 4-month-old male infant with intestinal obstruction underwent explorative laparotomy. An intussusception of a small mass in the diverticulum wall was found at surgery, which revealed to be a Gangliocytic Paraganglioma. The occurrence of this type of tumour is peculiar in children and has never been reported in infants and in association with Meckel's diverticulum and intestinal intussusception.

Transanal protrusion of intussusception can be sign of Waugh syndrome

Intussusception rarely occurs with transanal prolapse of intussusception (TAPI), this presentation may be a sign of Waugh's syndrome (WS), an association between intestinal malrotation and intussusception. The authors present the case of infant with an episode of TAPI, resolved with air enema, who required later diagnostic tests that showed the presence of WS, for which surgery was required after the resolution of the intussusception. At now we found only 72 cases reported of WS and some of them clinically presented with TAPI. In our opinion, patients with this type of presentation require a thorough radiological study of the intestine to rule out intestinal malrotations.

INTUSSUSCEPTIONS IN ADULTS (ABOUT 06 CASES)

Background : Intussusception in adults is a rare condition that is difcult to diagnose due to its clinical polymorphism. Its diagnosis has become easier thanks to advances in medical imaging. The treatment of intussusceptions in adults is surgical because of the high incidence of causative organic lesions. Our work is a prospective study which aims to determine theObjective : clinical and etiological peculiarities of acute intussusceptions in adults, to specify the diagnostic and therapeutic difculties and to draw practical conclusions regarding the optimal therapeutic management of this rare condition. Our work is a retrospective study,Materials and methods: covering a series of 06 cases of acute intussusception operated on in the visceral surgery department of the Avicenne Military Hospital in Marrakech, over a period of 6 years, from January 2014 to May 2020. Data relating to clinical features, diagnosis, treatment and histological reports were collected and analyzed. Six cases of acute intussusceptions in adults were collected over a period of six years, amountingResults: one case per year. The average age was 52 with a female predominance of 66%. Four out of 6 patients had been seen urgently. The diagnosis was made preoperatively in all cases, ie 100% by using ultrasonography and CT. The ultrasound showed a "target" image in one case and a "pseudo- kidney" image in another. CT made it possible to make the diagnosis in all cases, and objectied an etiological diagnosis in 4 patients, ie 66.6% of cases. The pure enteric form was the most frequent (3 out of 6 cases), ie 50% of cases. There was one case of intestinal necrosis. Bowel resection was performed in 6 cases, or 100%. The cause of intussusception was found in all patients, including a benign tumor cause in 66.6% of cases. The immediate postoperative follow-up was straightforward in all patients We can conclude that the acute intussusception in adults is aConclusion: rare entity that should be considered in any patient with subacute abdominal pain. And we propose that oncological resection should be carried out in all cases of intestinal intussusception without attempting reduction regardless the site of the invagination, In view of the high rate of malignancy.

Jejunal intussusception on jejunostomy tube: A rare cause of occlusion in adults.

IntroductionAcute intestinal intussusception (AI) in adults secondary to jejunostomy is a rare complication and a surgical emergency requiring early diagnosis and treatment.Presentation of caseWe report the case of a 44-year-old patient, without medical history, who presented dysphagia after caustic ingestion. The patient underwent a Witzel feeding jejunostomy. The evolution was marked by the installation of abdominal distension with vomiting and alteration of the general state, the diagnosis of an intussusception in the jejunostomy tube was made in the abdominal CT scan, which required a surgical intervention, and reduction of intussusception, with simple after effects.DiscussionAcute intestinal intussusception (IIA) secondary to jejunostomy tube placement is a rare abdominal emergency. It manifests with signs of upper gastrointestinal obstruction. Diagnosis is based on abdominal imaging by ultrasound or CT scan. Treatment is most often surgical (Chavrier et al., 1992) [1].ConclusionWe present a very rare example of acute intestinal intussusception in adults, complicating jejunostomy, with non-specific clinical signs, which needed an early radiological diagnosis for adequate management.

A CASE OF RENAL CELL CARCINOMA WITH SMALL INTESTINE METASTASIS DURING NIVOLUMAB PLUS IPILIMUMAB

A 71-year-old man with a history of hoarseness and right upper extremity numbness was referred to our department for evaluation of an intrathoracic mass that was detected on chest radiography and a right kidney tumor observed on computed tomography (CT). Histopathological examination of percutaneous kidney biopsy and bronchoscopic lung biopsy specimens revealed renal clear cell carcinoma with multiple lung metastases. The patient showed a poor risk based on the International Metastatic renal cell carcinoma Database Consortium score, and nivolumab plus ipilimumab were initiated as first-line therapy. His symptoms gradually improved, following four courses of nivolumab plus ipilimumab treatment, and CT revealed shrinkage of all lesions. However, he developed diarrhea, rash, anemia, and elevated serum C-reactive protein levels (CRP) following this therapy. Diarrhea and rash were considered immune-related adverse events, and he was treated with oral prednisolone and topical corticosteroid. Nivolumab administration was discontinued because anemia worsened together with elevated serum CRP levels despite improvement in diarrhea. He subsequently developed constipation and abdominal bloating, following further treatment for 4 months. CT revealed intestinal tumor-induced intussusception, necessitating partial resection of the small intestinal tumor, which was histopathologically diagnosed as metastases. Both anemia and elevated CRP improved postoperatively. Currently, all metastatic lesions other than the resected intestine have continued to respond to treatment over 12 months after initiation of nivolumab plus ipilimumab therapy.

CT Diagnostics of Intestinal Obstruction Caused by Invagination Due to the Jejunal Wall Lipoma

A rare case of jejunal lipoma complicated by intestinal intussusception in a 71-year-old man is presented. Abdominal computed tomography revealed intestinal intussusception caused by the jejunal wall lipoma, allowed to timely make a diagnosis and perform surgical treatment.

A rare acute abdomen cause: intestinal perforation and invagination secondary to malignant melanoma metastasis

Malignant melanoma (MM) is a tumor with high metastatic potential. The small intestine is the third most common metastasis area for MM. Intestinal obstruction, intussusception, hemorrhage, and perforation have been determined as the clinical presentation in patients who were admitted to the hospital because of abdominal pain, weakness, constipation, weight loss, and palpable abdominal mass. Presentation as perforation is rarer than the other clinical presentations. We report the case of a patient with metastatic MM, who attended the emergency department because of acute abdomen. Perforation and invagination due to metastatic lesions were cured by surgical intervention. Possible metastasis should be considered in patients with active complaints or in patients scheduled for emergency intervention, as in our case, if there is a history of MM. Possible metastasis should be considered in preoperative planning, information, and anticipation of the operative procedure.

An unusual cluster of Waugh syndrome as a cause of intestinal obstruction in children - A case series.

Introduction and importanceThe association of intussusception with intestinal malrotation is a rare phenomenon named Waugh syndrome by Brereton et. It is a rare disease entity with less than 100 cases described so far. A cluster presentation is something unusual for rare diseases.Case presentationAll four patients have presented with features suggestive of bowel obstruction as all of them have had colicky abdominal pain. Three patients have vomiting as an additional complaint, so as the diarrhea. Fever has also been reported in one patient. Patients have presented in 6 months period, non-consecutively. Abdominal pain, diarrhea and vomiting are alarming in the pediatric population. When each case presented, an immediate resuscitation was performed including IV lines, nasogastric suctioning, electrolytes correction, and blood and FFP transfusion as necessary. Abdominal ultrasonography was performed revealing target sign. After optimization for surgery, manual reduction of the intussusception was done followed by a Ladd's procedure for the malrotation was performed for all 4 patients with excellent outcomes.Clinical discussionWith the surgery, after case optimization, remains the standard of care; the presence of cluster presentation for Waugh syndrome could suggest that some environmental factors might be implicated and further observations can be carried out to look more into such phenomenon.ConclusionWaugh syndrome, a combined presentation of intestinal malrotation and intussusception, is a rare syndrome that can present in children. Optimization for surgery followed by a 2-step surgical approach is the usual treatment with excellent outcomes described.

Giant bezoar causing recurrent abdominal pain in a young girl with autism spectrum disorder

A giant bezoar fulfilling the stomach, the duodenum and the jejunum for about 60–70 cm was found in a young girl with autism spectrum disorder, admitted for acute abdominal pain. At initial radiological evaluation an intestinal ilea-ileal intussusception was diagnosed but a computed tomography showed hypointense material with a chambered aspect likely due to accidental ingestion of exogenous material. The presence of a giant bezoar was endoscopically confirmed and the patient underwent surgery for its manual removal.

Colocolic intussusception secondary to colonic adenocarcinoma with impending caecal perforation in an elderly patient: A rare case report.

IntroductionIntussusception is a surgical emergency in which a part of the intestine slides into the distal adjacent part. Adult colocolic intussusception secondary to a tumoral process is a rare but serious clinical condition requiring immediate surgical intervention.Case presentationWe report a case of a 65-year-old male patient presenting with abdominal pain and distention, subsequently diagnosed with colocolic intussusception in the descending colon with closed-loop bowel obstruction with impending caecal perforation. An exophytic mass on the descending colon was discovered intra-operatively, prompting a subtotal colectomy with ileosigmoidal anastomosis and loop ileostomy with the suspicion of malignancy. The histopathological examination of the surgical specimen concluded a moderately-differentiated colonic adenocarcinoma with 40% mucinous component.Clinical discussionAdult intestinal intussusception is a rare but serious condition differing greatly in etiology from its pediatric counterpart. Its preoperative diagnosis is challenging in adults, which appears to be due to its imprecise presenting signs and symptoms; thus, the condition can be mistaken for other causes of intestinal obstruction. Adenocarcinomas remain the most common cause of malignant tumors in the colon, which also makes them one of the causes for colocolic intussusception.ConclusionIntussusception can appear as a surgical emergency even in the elderly, necessitating prompt surgical intervention to avoid intestinal ischemia and gangrene. Its diagnosis can be aided to a great degree by CT imaging.

Intussusception in a Newborn. Clinical Observation

Intestinal intussusception in a newborn is a casuistic rarity, the clinical symptoms of which are nonspecific, and patients are regarded for a relatively long time as patients with necrotic enterocolitis. There are no unambiguous radiological signs of this pathology, especially with atypical variants of intussusception, when even pneumoirrigography is uninformative. In the vast majority of cases, the diagnosis is made only intra-operatively, when the development of intestinal obstruction or perforated peritonitis determines the need for surgical intervention. The publication presents a unique observation of preoperative echographic diagnosis and successful cure of prolonged small-intestinal invagination in a premature newborn 2 days of life, the cause of which was Meckel’s diverticulum.

Intussusception in a Newborn. Clinical Observation

Intestinal intussusception in a newborn is a casuistic rarity, the clinical symptoms of which are nonspecific, and patients are regarded for a relatively long time as patients with necrotic enterocolitis. There are no unambiguous radiological signs of this pathology, especially with atypical variants of intussusception, when even pneumoirrigography is uninformative. In the vast majority of cases, the diagnosis is made only intra-operatively, when the development of intestinal obstruction or perforated peritonitis determines the need for surgical intervention. The publication presents a unique observation of preoperative echographic diagnosis and successful cure of prolonged small-intestinal invagination in a premature newborn 2 days of life, the cause of which was Meckel’s diverticulum.

Intestinal intussusception in an Adult: Case report

Intestinal intussusception is a rare entity in which a segment of intestine (intussusceptum), contracted by a peristaltic wave, enters the immediately distal segment (intussuscipiens). Once trapped, the invaginated segment is propelled distally by peristalsis, dragging its mesentery behind it. Next, we present the case of a 41-year-old female patient who presented an intestinal intussusception, with clinical manifestations of an intestinal obstruction and underwent an exploratory laparotomy, where the diagnosis was made and a moderately adenocarcinoma-type colon lesion was resected. Differentiated, in the city of Barranquilla in 2016.

Jejunal intussusception due to an atypical lipomatous tumor: a rare case report.

Intussusception in adults is rare, and the clinical symptoms of intussusception are subtle, making the diagnosis quite challenging. Gastrointestinal lipomas are rare benign tumors and are essentially adipose growths, most frequently found within the small intestine wall or mesentery. Limited up-to-date evidence exists regarding such lipomas. Intussusception due to a gastrointestinal lipoma constitutes an infrequent clinical entity, and the diagnosis of duodenal lipoma mainly depends on endoscopy examination, supplemented by computed tomography and magnetic resonance imaging. The present report describes a case of jejunal intussusception in an adult with a history of intermittent colicky abdominal pain located in the left upper quadrant over the last month. Contrast-enhanced computed tomography of the abdomen showed the typical target sign of a small intestinal intussusception along the left upper quadrant and a well-defined, low-density tumor in the intussusception. Exploratory laparotomy revealed jejuno-jejunal intussusception secondary to a lipoma, which was successfully treated with segmental intestinal resection.

A suspected intermediate syndrome and intussusception following propoxur toxicity in a dog

AbstractAn 8‐month‐old, mixed breed dog was referred because of vomiting, generalised muscle tremors and miosis. A few hours before the presentation, the owners saw the dog eating something during the daily walk. The dog was initially treated with fluids, atropine, dexmedetomidine, maropitant and midazolam. Complete blood exams showed a marked reduction of cholinesterase activity. Blood toxicology tests revealed the presence of propoxur. Twenty‐four hours after the presentation, the dog developed a small intestinal intussusception. After an initial improvement, the dog developed weakness and respiratory difficulties. The neurological examination showed obtundation, severe generalised muscle weakness of neck and limbs, reduced flexor reflexes in the four limbs and a short and shallow respiratory pattern, suggesting suspected intermediate syndrome. The dog's neurologic conditions progressively improved, and he was discharged 5 days after presentation with only mild impairment of the neck strength.