scholarly journals An Unusual Presentation of Small Bowel Intussusception

Author(s):  
Yinglin Gao ◽  
Cheikh Talal El Imad ◽  
Hai Song Kim ◽  
Vivek Gumaste

Adult small bowel intussusception is a very rare entity that accounts for 5% of all cases of intussusception and 1%–5% of intestinal obstructions. It is more common in children but can occur in adults. It is an important etiology to consider when a patient presents with recurrent abdominal pain. The diagnosis can be challenging as symptoms are nonspecific and include abdominal pain, nausea and vomiting. This paper presents a rare case of duodenal intussusception, followed by a review of the literature discussing the diagnosis and treatment of adult intussusception.

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Daniel Kakish ◽  
Marwan Alaoudi ◽  
Brian Welch ◽  
David Fan ◽  
Melissa Meghpara ◽  
...  

Abstract Intussusception occurs when one portion of bowel ‘telescopes’ into another due to a lead point created by a range of benign or pathologic process. Intussusception mostly occurs in children. Although adult intussusception (AI) is rare, accounting for <5% of intestinal obstructions, it is more concerning in adults as malignancy accounts for nearly 65% of lead points in AI. Patients present with severe abdominal pain concerning for an acute abdomen along with a degree of bowel obstruction. We have experienced a total of 11 patients within recent years presenting with symptoms of an acute abdomen due to AI. None of these patients were found to have a pathologic process creating a lead point. However, we found that all of them were marijuana users. In this report, we compare their management, hospital course and review of the literature discussing proposed mechanisms that suggest an association between cannabis and intussusception.


1970 ◽  
Vol 8 (3) ◽  
pp. 158-165 ◽  
Author(s):  
Rakesh Kr Gupta ◽  
Chandra Shekhar Agrawal ◽  
Rohit Yadav ◽  
Amir Bajracharya ◽  
Panna Lal Sah

Background: Intussusception is a different entity in adults than it is in children and is usually secondary to a definable pathology. Objective: To review adult intussusception: clinical features, diagnosis and their management. Subjects and methods: A retrospective review of 38 cases of intussusception in individuals older than 18 years of age presenting to BPKIHS Dharan, Nepal from January 2003 to December 2009 was done. Results: In six years, there were thirty-eight patients of surgically proven adult intussusception. The patients. mean age was 49.6 ± 16.2 years, M: F ratio was 1.3:1. Intestinal obstructions of various extents were the commonest presentation in twenty-seven patients (71%). There were 42% enteric, 32% ileocolic and 26% colonic AI. The diagnostic accuracy of the ultrasonography was 78.5%, CT scan was 90% and colonoscopy was 100%. The pathological lesions were found in 94% of AI. Among the pathological lesion, enteric have 62% benign, 38% malignant, ileocolic have 50% benign, 50% malignant, and in colocolic 70% malignant, 30% benign. In enteric AI, 68% were reduced successfully, 25% reduction was not attempted. Of ileocolic AI, 58.3% were reduced successfully, 41.6% had resection without reduction. Of colocolic AI, 30% of them were reduced successfully before resection, 70% had resection without reduction. Conclusion: CT scanning is the most useful diagnostic radiologic method in AI. Colonoscopy is the most accurate in ileocolic and colonic AI. Small-bowel intussusception should be reduced before resection if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly malignant. Keywords: Adult intussusception (AI); Bowel obstruction; CT scan DOI: 10.3126/hren.v8i3.4208Health Renaissance, September-December 2010; Vol 8 (No.3);158-165


2021 ◽  
Vol 8 (8) ◽  
pp. 2498
Author(s):  
Praveen Gnanadev ◽  
Mukund . ◽  
Hariprasad Ramachandra Naidu Taluru ◽  
Rohit Krishnappa ◽  
Vinayak Hiremath ◽  
...  

Intussusception is defined as the telescoping of a segment of the gastrointestinal tract (intussusceptum) into an immediately adjacent distal bowel (intussuscipiens), causing venous congestion, edema, and blood supply reduction. Adult intussusception is a rare entity which can be with or without lead-point. Cases without lead-point frequently occurs in children or adults with celiac disease and Crohn’s disease and with lead point is caused by an underlying neoplasm, benign or malignant frequently presenting with bowel obstruction and acute abdomen. A 41-years-old male presented to our outpatient clinic with a history of recurrent abdominal pain. The clinical presentation and CT scan findings led to the diagnosis of ileoileal intussusception. Subsequently he underwent laparotomy which revealed an ileal intussusception, which was investigated and was found to be of Crohn’s etiology.


2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
N. Srikant ◽  
Shweta Yellapurkar ◽  
Karen Boaz ◽  
Mohan Baliga ◽  
Nidhi Manaktala ◽  
...  

Polycystic (dysgenetic) disease of the salivary glands is a rare entity that has only recently been described in the literature. The disease is more commonly seen in females and majority of the cases have presented as bilateral parotid gland swellings. This case presenting in a 21-year-old male is the first of this unusual entity involving solely the minor salivary gland on the lower lip. This case report highlights the importance for the clinician to be aware of this differential diagnosis, when treating an innocuous lesion like a mucocele.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Armin Fardanesh ◽  
Jamie Powell ◽  
Maitham Al-Whouhayb

Abstract Introduction Roux-en-Y Gastric bypass (REYGB) amounts for a third of surgical bariatric interventions. Small bowel obstruction (SBO) is a long-term complication in REYGB and can be caused by intussusception of bowel, in approximately 0.5% of procedures.  Intussusception in REYBG is mostly attributed to dysmotility. This report demonstrates a rare case of intussusception in REYGB secondary to a benign polyp.  Case description A 45 year old female, three years post REYGB, presented to A&E with acute, extreme upper abdominal pain, with three days absolute constipation. She was tender on examination with normal blood tests. CT scan demonstrated small bowel intussusception. Initial concerns were of intussusception of the jejuno-jejunostomy anastomosis causing SBO.  She had an exploratory laparotomy, which confirmed intussusception, however this was 20cm distal to the jejuno-jejunostomy. Bowel was gently reduced, and deemed viable. On thorough run-through, a small segment at the transition point, was considered abnormal on palpation. This region was resected and a 1x1cm intraluminal polyp was identified as the causative lead point. The patient did well postoperatively.  Discussion Small bowel intussusception in adults is typically attributed to pathological lead point, such as benign or malignant lesions. Intussusception in REYBG is a rare but well-documented cause of intestinal obstruction, usually attributed to dysmotility, secondary to ectopic pacemaker cells particularly around anastomoses. In this case, the intussusception was caused by an unusual pathology separate from the jejuno-jejunal anastomosis. We recommend thorough examination of all adjacent bowel to exclude lesions, in this case a polyp, which could result in recurrence. 


2021 ◽  
Vol 12 ◽  
pp. 370
Author(s):  
Vishal Vishnu Thakur ◽  
Ranjit Devidas Rangnekar ◽  
Shashank Aroor ◽  
Krishnakumar Kesavapisharady ◽  
Mathew Abraham

Background: Spinal intramedullary cysts present a radiological dilemma. We present a rare case of a conus intramedullary arachnoid cyst and report on its differentiating features and management. Case Description: We report a case of a 30-month-old child who presented with decreased gluteal sensation and urinary dribbling for 6 months. Apart from some slowness in walking, the power was normal in all four limbs. Imaging showed a non-enhancing, T2-weighted hyperintense 12 × 8 mm conus intramedullary cyst without any edema. A T12-L1 laminotomy followed by marsupialization of the cyst was done. Histopathology was suggestive of an arachnoid cyst. The postoperative course was uneventful with improvement in muscle strength and achievement of regular milestones. We also present the pertinent review of the literature to date. Conclusion: Intramedullary arachnoid cysts are a rare entity and should form the differential diagnosis for cysts presenting in the conus medullaris. Simple decompressive options may suffice for symptomatic cases and radical excision may be avoided. A high index of suspicion is essential considering the subtle nature of presenting symptoms.


PEDIATRICS ◽  
1961 ◽  
Vol 28 (4) ◽  
pp. 655-661
Author(s):  
James E. Wenzl ◽  
Lloyd G. Bartholomew ◽  
George A. Hallenbeck ◽  
Gunnar B. Stickler

A case is reported in which a child had gastrointestinal polyposis associated with mucocutaneous pigmentations (the Peutz-Jeghers syndrome). He experienced severe recurrent abdominal pain caused by intermittent intussusception. Removal of the grossly palpable polyps from the small intestine and stomach controlled his symptoms. On the basis of a review of the literature it has become apparent that this disease may first become manifest during childhood. The symptoms are primarily those of recurrent abdominal pain and gastrointestinal bleeding in the presence of mucocutaneous pigmentation. The prognosis associated with this disease is excellent, and the risk of malignant change, if it really exists, is minimal. For this reason, it is urged that surgical treatment be conservative rather than radical, to avoid unnecessary loss of intestine.


2021 ◽  
pp. 22-23
Author(s):  
K.Prasanth Kumar ◽  
A.D.V. Lavanya ◽  
P.Surendra Reddy

Mesenteric cysts are rare and occur in patients of any age. They are asymptomatic and found incidentally or during the management of their complications. They commonly originate from the small bowel mesentery, although a proportion of them have been found to originate from the mesocolon (24%) and the retroperitoneum [1] [2,3,4,5] (14.5%). A mesenteric cyst originating in the sigmoid mesocolon is a very rare nding. They are a rare cause of abdominal pain and are discovered incidentally. If symptomatic, patients with these cysts present with abdominal pain, vomiting and low backache. Performing a thorough physical examination and conducting radiological investigations like ultrasonography (USG), computed tomography (CT) are keys in diagnosing the mesenteric cysts.


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