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PubMed1988

Hydronephrosis secondary to colonic intussusception.

We report on a two-month-old infant with bowel obstruction found to be secondary to a colonic intussusception (proved and reduced by barium enema). The finding of renal insufficiency prompted ultrasonographic renal evaluation uncovering a unilateral hydronephrosis. After resolution of the intussusception and hydration, the infant's renal functions normalized. Follow-up ultrasound study and renal scan showed resolution of the hydronephrosis. We conclude that colonic intussusception can cause renal obstruction.

Colonic Diseases↗
PubMed1989

Postoperative intussusception in children.

Intussusception in the postoperative period is an unusual yet potentially fatal surgical complication. We present 3 illustrative cases and contrast postoperative intussusception with the more common classic childhood intussusception. Physician awareness of this condition is critical for early recognition and treatment.

Child, Preschool↗
PubMed1989

Intussusception secondary to Meckel's diverticulum. A challenging diagnosis in adolescence.

A 14-year-old male was found to have an intussusception secondary to an invaginating Meckel's diverticulum. He was initially referred for crampy abdominal pain and diarrhea, and inflammatory bowel disease was suspected. The etiology of most intussusceptions is unknown; however, both in adolescence and adulthood they may be initiated by a lead point. This paper presents, analyzes, and discusses an intussusception caused by a Meckel's diverticulum as a lead point and the difficulty in making a preoperative diagnosis.

Adolescent↗
PubMed1992

Changes in the presentation of intussusception.

Intussusception is most often diagnosed in well-nourished 7- to 10-month-old infants, but may be overlooked in older children. From 1985 to 1991, we treated 118 boys and 62 girls ranging in age from 2 months to 15 years (average, 22.6 months). Thirty-seven percent were older than 2 years, significantly more than in earlier experience at this institution. Overall, children with intussusception had a less than average weight (P < .05). The majority of intussusceptions in all age groups were idiopathic. Seventy-three percent of the patients were treated successfully by barium enema. The presence of air-fluid levels on the plain radiograph decreased the success rate of barium enema reduction from 81% to 49%. Barium enema reduction should nevertheless be attempted regardless of the age of the patient or the duration of symptoms, and routine surgical exploration is never recommended.

Adolescent↗
PubMedDate not supplied

Intussusception in the adult--a rare disease.

We present two cases of intussusception in the adult. Both cases were secondary to a benign lipoma as the lead point. These cases represent typical cases of adult intussusception, a rare disease characterized by insidious onset, vague abdominal symptoms, and elusive diagnosis. A diagnostic and therapeutic approach to adult intussusception is suggested. The need to consider this rare entity in the differential diagnosis of chronic abdominal complaints in the adult is emphasized.

Adult↗
PubMedDate not supplied

Unusual cases of intussusception.

Intussusception occurs most commonly in the first five years of life and is classically associated with intense intermittent abdominal pain, vomiting, bloody mucoid diarrhea, and a palpable abdominal mass. These cardinal findings are frequently not present, however, particularly outside the usual age range. The emergency physician must therefore be vigilant in considering intussusception as a potential cause for intestinal obstruction in all patients, if ischemic complications are to be avoided. We present three cases of "unusual" intussusception, and provide a review of this entity and a guide to its consideration and work-up in the emergency department.

Adult↗
PubMed2006

Utility of hospital admission after successful enema reduction of ileocolic intussusception.

BACKGROUND: In-hospital observation of 24 to 48 hours has been the standard practice after successful enema reduction (ER) of ileocolic intussusceptions, but this practice has not been validated. We evaluated retrospectively the safety of short-term emergency department observation. METHODS: Between April 2000 and October 2004, 121 patients presented to the emergency department with ileocolic intussusception, and all had ER attempts. RESULTS: Ninety-six patients had successful reduction, 25 were excluded for failed reduction or unconfirmed diagnosis, and another 16 needed observation anyway for high white blood count or persistent postreduction pain. Of the remaining 80 patients, the mean time from symptoms to reduction was 45.9 hours (4 hours to 10 days). All patients, except one, were admitted for observation for a mean period of 1.6 days (8 hours to 6.5 days). No complications were associated with air ER; however, 6 (7.5%) patients had reintussusception during the observation period and 5 (6.3%) recurred after discharge. The mean intervals for recurrence postreduction were 17.8 hours and 14.5 months with no mortality or morbidity in either. CONCLUSIONS: Short-term emergency department observation could be a safe practice in more than 90% of the selected cases, recurrence of intussusception outside the hospital is not associated with unfavorable outcome, and routine admission is not warranted.

Adolescent↗
PubMed2006

Small bowel intussusception after blunt abdominal trauma in a 6-year-old boy: case report and review of 6 cases reported in the literature.

Although intussusception is a well-known cause of acute abdomen in the pediatric population, traumatic intussusception is exceedingly rare and has been reported previously only 6 times in a preadolescent child. We present a case of ileoileal intussusception in a previously healthy 6-year-old boy after blunt trauma to the abdomen and review the English language literature on the subject.

Abdominal Injuries↗
PubMedDate not supplied

Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication.

Obstruction of the small intestine is a recognized complication after Roux-en-Y gastric bypass surgery for morbid obesity. Reported causes after bariatric surgery include volvulus, adhesion, internal hernia, hemorrhagic bezoar, incarcerated ventral hernia, and intussusception. Intussusception after Roux-en-Y gastric bypass for morbid obesity is rare. The etiology remains largely obscure. A delay in the diagnosis and management may result in catastrophic outcomes. Management should include the early involvement of a bariatric surgeon. We describe the clinical and radiologic presentation of a case of jejunojejunal intussusception 4 years after open Roux-en-Y gastric bypass.

Adult↗
PubMed2005

Evaluation of the Brighton Collaboration case definition of acute intussusception during active surveillance.

To evaluate the Brighton Collaboration case definition of acute intussusception, we reviewed all episodes reported to the Swiss Paediatric Surveillance Unit (SPSU) during 1 year (4/2003--3/2004). Of 96 confirmed episodes 86 (90%, 95% CI 83--96) were captured by the case definition. Of the remaining 10 episodes, 9 resolved spontaneously following presentation with clinical signs and symptoms, and ultrasound findings compatible with intussusception. Eighty-two episodes met level 1 of the definition, the highest level of diagnostic certainty. Compared to level 1, the sensitivity of level 2 (intermediate level) and level 3 (lowest level) was 65% (CI 55--74) and 30% (CI 20--40), respectively. In conclusion, the case definition was useful and applicable to assess the background rate of intussusception in the light of potential future rotavirus immunization.

Child, Preschool↗
PubMed2005

Intussusception and rotavirus vaccines.

The association between the first oral rotavirus vaccine to be licensed in the U.S. (Rotashield) and intussusception has presented a major challenge to the effort to reduce the global burden related to rotavirus infection. Although the risk of developing intussusception following immunization with Rotashield is low, debate continues about the estimation of intussusception risk and the events surrounding the withdrawal of the vaccine. The experience with Rotashield has highlighted the wisdom of parallel clinical trials in developing and developed countries and the value of post-licensure surveillance for the detection of uncommon adverse events. This review retraces the steps leading up to the withdrawal of the Rotashield vaccine and reflects on how this experience has influenced the development of other rotavirus vaccines.

Clinical Trials as Topic↗
PubMed1993

Effective dose during screening monitored intussusception reduction.

A retrospective survey of 58 intussusception reductions in 55 patients is presented. During the period studied, the department changed from the use of barium to air as a reduction medium. The reduction rates were 86% with air (37 procedures) compared to 67% with barium (21 procedures). The complication rates were similar. The use of a dose-area product meter enables effective dose to the patient to be assessed. The median effective dose to the patient is 55 microSv, and the 75 percentile dose is 75 microSv. A table to estimate effective dose to the patient during the procedure is presented. This study confirms previously quoted advantages of pneumatic reduction over hydrostatic reduction of intussusception but finds no significant difference in dose between air and barium reduction. We believe that it should be possible to submit the patient to a dose of 75 microSv or less during intussusception reduction under screening control.

Air↗
PubMed1978

Transient small bowel intussusception in adult coeliac disease.

Considerable disagreement exists in the literature concerning the occurrence and incidence of transient non-obstructive intussusception in adult coeliac disease. Only a few case reports have been published and several standard texts do not mention the association at all. We report six adult patients, all with coeliac disease, who demonstrated transient non-obstructive intussusception on small bowel meal examination. The technique of the small bowel meal and the radiological signs of malabsorption are briefly described. The literature is reviewed and reasons for the disagreement herein are discussed. We conclude that the incidence of finding intussusception in adult coeliac disease is related to the intensity of searching and in our series this association was seen in at least 20% of cases. It is considered to be an additional radiological sign of coeliac disease although in no case did it occur in the absence of other prominent radiological evidence of malabsorption.

Adult↗
PubMed1980

Intussusception and total body opacification.

Because of atypical clinical presentations, two children with intussusception had intravenous urography as their initial examination of following plan films. In both patients the intussusception was outlined by an opaque rim due to the total body opacification effect on the bowel wall. One patient had a target-like blush on following films which strongly suggested the correct diagnosis. The authors do not advocate intravenous urography to diagnosis intussusception, but if this study is performed because of atypical clinical findings, the radiographic sign should be recognized and lead to a barium enema.

Female↗
PubMed1980

Lateral wall cecal filling defects following successful hydrostatic reduction of cecalcolic intussusceptions.

Two children less than 1 yr of age were found to have a lateral wall filling defect following successful hydrostatic reduction of cecalcolic intussusceptions. Both filling defects were thought to be due to invagination of the lateral wall between the tinea coli. One child was explored due to recurrence of the intussusception despite despite a decrease in size of the filling defect. In the second child the filling defect had disappeared three days after the initial barium enema reduction. When confronted with a typical cecal filling defect in an infant following successful reduction of a cecalcolic intussusception, we believe that one is justified in assuming a cautious "wait and see" attitude. If the child recovers clinically the barium enema may be repeated in three days to access reduction in size or disappearance of the filling defect.

Barium Sulfate↗
PubMed1980

A case of neonatal intussusception.

A case of ileocotic intussusception in a 48-hr-old neonate due to saccular duplication of the terminal ileum is presented. The unique nature of intussusception due to a leading point is underscored and the case for early surgical intervention is emphasized. Barium enema examination is stressed as a prime diagnostic tool whenever intussusception is suspected.

Barium Sulfate↗
PubMed1983

Blue Rubber Bleb Nevi as a cause of intussusception.

The Blue Rubber Bleb Nevus syndrome is a rare disease characterized by a distinctive type of hemangioma which involves the skin and the gastrointestinal tract. In the latter location, these lesions are often responsible for chronic blood loss and secondary anemia, and in rare situations may act as a leading point for an intussusception. The diagnosis of intussusception in children older than 3 or 4 yr is frequently difficult and delayed. In a child with typical skin lesions of the Blue Rubber Bleb Nevus syndrome, an acute illness with manifestations of intestinal obstruction should indicate the possibility of an associated intussusception.

Child↗
PubMed1986

Idiopathic colo-colic intussusception.

A three-month-old infant presented with transverse colon intussusception. Rapid progression of the illness and inability to reduce the intussusception by hydrostatic barium examination characterize the clinical course of this condition. At operation, no leading point was found, however, the entire colon was not fixed to the parietal peritoneum. Mobility of the colon may have contributed to the formation of this peculiar intussusception.

Colonic Diseases↗