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PubMed1986

[A case of intussusception due to intestinal metastasis of renal carcinoma].

Adult intussusceptions due to metastatic intestinal-tumor are very rare. A 71-year-old man with an intussusception due to intestinal metastasis of renal carcinoma is reported. To our knowledge, this is the third such patient in the Japanese literature. The patient was suffered from an intestinal obstruction six months after his renal carcinoma was detected. Laparotomy was performed, revealing that he had developed a jejunojejunal intussusception due to metastasis of renal carcinoma. The early diagnosis of metastatic intestinal tumor is difficult. It is important to bear in mind that patients with malignant tumor may already have metastasis.

Adenocarcinoma↗
PubMedDate not supplied

Intussusception in adults--report of 3 cases.

Intussusception in the adult is rare. The cases reported here illustrate the usual clinical development of the condition: incomplete, subacute, or chronic subobstruction. Intussusception is usually associated with a localized lesion, mostly a small bowel benign tumor, and a colonic malignant tumor. Diagnosis is effected using barium enema, ultrasonography, or CT scanning. Treatment of intussusception requires surgical intervention.

Adult↗
PubMed1985

Intussusception in black children.

Seventy-six black patients with intussusception are reviewed. Infants (59%) presented with features similar to classic intussusception; ileocolic lesions were most common (80%) and a high resection rate (36%) was the sequel to delay in presentation. Children over 2 years of age (41%) presented with a pattern of 'tropical' intussusception in which primary colocolic lesions predominated (55%) and leading points were rare (3,5%). A high percentage of older children appears to characterize series from tropical areas. The relative proportions of these groups may vary between, and within, geographical regions and differing causes are likely. However, the management of both groups is similar. Hydrostatic reduction was not effective in those patients in whom it was attempted.

Child, Preschool↗
PubMed1979

Non-infantile intussusception.

In Europe and North America, most cases of non-infantile intussusception are associated with intestinal neoplasm. At the University College Hospital, Ibadan, Nigeria, the majority of cases of intussusception seen are ileocecocolic and cecocolic types. These are usually not associated with intestinal neoplasm and simple reduction is all that is required.Intussusception occurring in other segments of the intestinal tract is found to be associated with intestinal neoplasm, mesenteric lymphadenopathy, and ascaris worms. The very mobile cecum and ascending colon found in this population may be related to the high incidence of ileocecocolic and cecocolic intussusception.Indications for resection of intussusception include presence of intestinal neoplasm, irreducibility, gangrenous bowel, and chronicity.

Adolescent↗
PubMed1968

Intussusception in adults.

Three cases of intussusception in adults were observed within a period of six months in a small general hospital. All the patients were over 65 years old and all were admitted to hospital with intermittent cramping abdominal pains. None appeared to be in acute distress. In all three, body temperature, pulse rate and hemogram were within normal limits. Diagnosis was made preoperatively after barium enema studies. Bowel resection with end-to-end anastomosis was done in all three cases, in two because of gangrenous bowel. The site of intussusception was jejunojejunal in one case, ileocecal in another and colorectal in the third; and the cause in all cases was tumor, benign in two cases, malignant in one. The patients recovered uneventfully except for incisional abscess and diarrhea of seven days' duration in one. In a review of literature it was found that the clinical features in these three cases closely paralleled those of other cases of adult intussusception reported in this country.

Aged↗
PubMed1983

Intrauterine intussusception: case report and literature review.

Intussusception in the newborn is a unique clinical entity, and one of the most unusual causes of intestinal obstruction in infants. Its cause can be idiopathic, secondary to a local lesion or a complication of disease. Early diagnosis and treatment are important, because survival depends on them. The authors report a case of jejunal atresia secondary to intrauterine intussusception, followed by a literature review. Less than 30 cases have been adequately documented in the world literature. Eight reports from the literature are selected to highlight clues for early diagnosis, such as vomiting, with or without bile, abdominal distension and bloody stools, because of their prognostic implications. Intussusception is rare under the age of 3 months; the incidence is 0.3% in the neonatal period. Previous reports indicate that a confusing clinical picture has led to a delay in operation and a high mortality. The ultimate outcome depends on an acute awareness of the condition in the presence of the diagnostic clues in a newborn.

Female↗
PubMed1978

Factors leading to surgical treatment of intussusception.

We have reviewed the histories of 36 children treated operatively for 37 intussusceptions on one surgical service at this hospital during a period of ten years. Thirteen children had undergone operative procedures without attempted hydrostatic reduction. The only death that occurred was in a 800 gram premature infant. Pre-existing conditions altering intestinal motility were present in seven children. A definite lead point in the intestinal tract was present in six patients. Although hydrostatic reduction plays a major role in the management of uncomplicated intussusception in the pediatric age group, surgical treatment is sitll a necessary alternative for the management of intussusception.

Child, Preschool↗
PubMed1982

Intussusception associated with Anoplocephala perfoliata infection in five horses.

Intussusception associated with Anoplocephala perfoliata infection was found in 5 horses. The unusual types of intussusception and the presence of tapeworms at the leading edge of the intussuscipiens suggested tapeworms as the cause of the problem. Lesions attributable to tapeworm attachment on the mucosa were found to fit a mechanical model of intussusception. Treatment of two of the horses and some of their pasturemates with pyrantel pamoate caused elimination of intact tapeworms.

Animals↗
PubMed1982

Mechanism of perforation occurring in the intussuscipiens during hydrostatic reduction of intussusception.

Perforation of bowel during attempted hydrostatic reduction of an intussusception almost always occurs through the distal, apparently uninvolved bowel. It is probably never seen except in a group of at-risk children, under 6 months of age. It is not related to unduly high enema pressure, but to involvement of the blood supply in the intussusceptum and obstruction of the blood supply with resulting ischemic changes in the "apparently" uninvolved intussuscipiens. The authors provide support for their suggested mechanism by their findings at operation and in the resected specimens from seven children with an irreducible intussusception and one 5-month-old child whose bowel perforated during attempted hydrostatic reduction. Because children under 6 months of age are susceptible to perforation, hydrostatic reduction of intussuscepted bowel is contraindicated.

Colon↗
PubMed1982

Acute intussusception: a classic clinical picture?

57 patients with acute intussusception were admitted to the Children's Hospital Zurich between 1972 and 1979. All were treated surgically. One died, 7 needed a bowel resection, 9 intussusceptions were difficult and 32 easy to reduce. The retrospectively reviewed data show that the classic symptomatology, beginning suddenly in a healthy male (60%) under 3 years of age (91%) with attacks of colicky pain (81%), vomiting (93%), a palpable abdominal mass (72%) and rectal bleeding (72%), appears during the course of illness or may not be present at all. This leads to misdiagnosis, wrong treatment and worsening of the pathology. Blood per rectum, the most typical symptom, was present in the first hours of illness in only 5%, vomiting in 44% and colicky pain in 33% of the patients. A high degree of awareness is therefore necessary to diagnose intussusception during the first hours of illness, and particular stress must be laid on the accuracy of the diagnosis because reducibility and resection rate depend directly on the duration of the symptoms.

Acute Disease↗
PubMed1981

[Ileo-ileal intussusception over an islet of heterotopic gastric mucosa without Meckel's diverticulum].

Three laparotomies have been necessary to find the origin of intermittent episodes of abdominal pain for eleven years in a girl: appendectomy at the age of three, surgical exploration at nine, and emergency laparotomy at fourteen for acute intestinal obstruction: ileo-ileal, secondary iléo-colic intussusception, reduction and ileal resection discovering an 2 x 2 cm area of normal fundic gastric mucosa. Heterotopic gastric mucosa in the small bowel is a rare congenital anomaly (12 pediatric and 5 adult cases previously reported in the literature). These folds of gastric mucosa are located more often in the terminal ileum than in the jejunum and act as the leading part of intussusception: the clinical finding were usually those of subacute obstruction of the small intestine and can occur during several years before an intestinal obstruction leading to surgery: after reduction of the intussusception, intestinal resection must be done. Intestinal ulcerations due to peptic secretion of the ectopic gastric mucosa with intestinal bleeding and anemia or perforation are less frequent.

Adolescent↗
PubMed1978

Intussusception as a complication of partial gastrectomy. A case report.

The causes of postgastrectomy syndrome are multiple and differ in their relative frequency. Among the more unusual is intussusception of the small bowel into the stomach or into the jejunojejunostomy. We describe a patient with acute retrograde intussusception of the efferent loop into the jejunojejunostomy occurring 14 months after partial gastrectomy with Billroth II anastomosis. Several theories regarding etiology are mentioned, among them functional causes, mechanical causes and derangements in stomal function. In our case, the circulatory derangement might possibly be a causal factor. The diagnostic problems are discussed, and the importance of early diagnosis is pointed out. A chronic form of intussusception is mentioned by several authors. Often the differential diagnosis is difficult, but epigastric pain, vomiting--ultimately of blood--and a palpable mass, constitute a classic triad. X-ray and endoscopy are supplementary aids to the diagnosis. Several types of operative treatment have been used, but no operative procedure seems to be fully effective as a safeguard against recurrence.

Aged↗
PubMedDate not supplied

Differential diagnosis between intussusception and gastroenteritis by plain film.

BACKGROUND: The objective of this study is to reassess the validity of plain film diagnosis for pediatric intussusception with consideration of the combinations of radiologic findings. METHODS: Sixty-six cases of intussusception and 81 controls of gastroenteritis were collected. Their films were read blindly by three radiologists together, with emphasis on nine radiologic findings: sparse colon gas (F1), sparse fecaloid content in colon (F2), gas-filled small bowel loops in right hypochondrium (F3), small bowel obstruction (F4), difficulty in assessing cecum position (F5), pneumoperitoneum (F6), discernible mass lesion (F7), target sign (F8) and crescent sign (F9). The sensitivity and specificity of individual findings and combinations of findings were analyzed. RESULTS: No cases showed F6. Listed in decreasing order of sensitivity, the other eight findings were F1, F5, F2, F7, F3, F4, F9 and F8. The sensitivity and specificity of these eight findings were inversely proportional with significant p-values (F8: < 0.005; the other seven findings: < 0.001). Sixty-three films (95%) in case group displayed combination of at least three radiologic findings. If the diagnostic criteria must consist of at least three radiologic findings, 60 cases (74%) of control group can be excluded. CONCLUSIONS: After eliminating the confounding effect of small bowel obstruction on the percentage of gas-filled small bowel loops in right hypochondrium and excluding the data agreed by only one radiologist from the study by Ratcliffe et al, the results of plain film findings were consistent with those of previous reports. The plain abdominal film can play an active role in the diagnosis of pediatric intussusception. Its validity increases when combinations of radiologic findings rather than individual signs are emphasized.

Adolescent↗
PubMed1995

Sigmoido-rectal intussusception.

Sigmoido-rectal intussusception is the least common type of intussusception seen in infants and children and is therefore usually misdiagnosed as rectal prolapse. Delay in diagnosis and treatment is due to lack of its awareness amongst surgeons, incomplete assessment of the prolapsed bowel at the anal orifice, and absence of classical traid of intussusception i.e. palpable abdominal mass, colicky abdominal pain, and bleeding per rectum.

Child↗
PubMedDate not supplied

Retrograde intussusception as a complication of Roux-en-Y anastomosis for choledochal cyst--report of one case.

A 19 month-old girl with choledochal cyst received complete cyst excision and biliary reconstruction by Roux-en-Y hepaticojejunostomy. Three months later, intestinal obstruction developed and small bowel intussusception was diagnosed preoperatively by ultrasonography. Laparotomy revealed retrograde jejunojejunal intussusception, involving the distal end of the Roux limb. To best knowledge, this is the first case in a child and the third case having such complication after Roux-en-Y anastomosis, reported in the literature. It should be noted that, if intestinal obstruction develops in a patient who had received this procedure for choledochal cyst, retrograde intussusception, although very rare, should be considered in addition to adhesion ileus.

Anastomosis, Roux-en-Y↗
PubMed1995

Intussusception of the cecum with calcified fecaliths.

We treated a patient with a complete invagination of the cecum that contained two large laminated calcified fecaliths. Colonofiberscopy showed a dimpling submucosal tumor that was palpated as a bony hard tumor at laparotomy. This finding suggested that the fecaliths caused intussusception of the cecum and that such an intussusception should be suspected when a bony hard, dimpling submucosal tumor is found in the cecum. To our knowledge, this is the first reported case of a cecal invagination accompanied by calcified fecaliths without an appendical intussusception.

Aged↗
PubMed1993

Intussusception reduction by hydrostatic saline enema under sonographical guidance: clinical experience in 33 cases.

During a three-year period from August 1988 to November 1991, 33 infants and children with 35 episodes of sonogram-proven intussusception were seen at the Department of Pediatrics at the Chiayi and Pingtung Christian Hospitals. Instead of a barium enema under radiological guidance, we performed hydrostatic reduction using a saline enema under sonographical guidance. The whole procedure was monitored and adequately controlled by real-time sonography. Thirty-two out of 35 episodes of intussusception were successfully reduced with no complications. The reduction rate was 91.4%. There were no abnormal findings in the intestines of those three patients who were operated on for unsuccessful reduction. The accessibility and safety of this new method of intussusception reduction makes it promising for the future.

Child↗
PubMed1993

Adult intussusception.

Intussusception occurs when one segment of bowel telescopes into an adjacent segment, resulting in obstruction and possible ischemic injury. The disorder is rare in adults. Most cases of adult intussusception have a demonstrable lead point. Benign and malignant tumors are the cause of intussusception in nearly two-thirds of adult cases. The diagnosis is often elusive because of the vague, chronic nature of the clinical presentation. Symptoms are usually suggestive of intermittent, partial intestinal obstruction. Barium studies or computed tomographic scans can be helpful in making the diagnosis. Surgery is required because of the high incidence of underlying pathology.

Adult↗