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PubMed2006

Retrograde gastric intussusception after myotomy for achalasia.

Retrograde gastroesophageal intussusception has been rarely reported in the literature. Risk factors include poor fixation of the stomach due to either long or loose mesenteric attachments; high intraabdominal pressure due to retching, physical exertion, or ascites; and hiatal hernia, which can lead to the development of a large gastroesophageal opening. An attempt at endoscopic reduction is reasonable, but laparotomy and manual reduction is usually required. We report a case of retrograde gastroesophageal intussusception in a patient with long-standing achalasia and two previous Heller myotomies.

Esophageal Achalasia↗
PubMed2005

The imaging of intussusception.

Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. It is relatively common in children and is the second most common cause of an acute abdomen in this age group. It is much less common in adults and accounts for less than 5% of cases of mechanical small bowel obstruction. Whereas the diagnosis is usually already suspected in children before imaging, it is often made unexpectedly in adults. In addition, although in children there is usually no specific underlying cause, an underlying lead point is often present in adults. Plain film radiography, barium studies and ultrasound imaging play major roles in both the diagnosis and management of this condition, and it is increasingly common for the diagnosis to be made by CT and MRI, particularly in adults. This pictorial essay reviews the imaging features that may be found in patients with bowel intussusception. As well as describing the imaging features of the more commonly used tests, we also stress the role of emerging technologies such as MRI using ultrafast half-fourier sequences with single shot turbo spin echo.

Abdomen, Acute↗
PubMed1992

Case report: obstructive jaundice secondary to an intussuscepting duodenal villous adenoma.

Small intestinal tumours are rare, forming 1% of all gastrointestinal tumours; most occur in the duodenum. Villous adenomas form only a very small proportion of the duodenal tumours. They usually occur in the periampullary region and show a marked propensity for malignant change. The usual mode of presentation is with non-specific pain, jaundice or occult bleeding. Obstruction and pancreatitis are infrequent clinical presentations. Intussusception secondary to a duodenal tumour of any histological type is rarer still. A case of intussusception of a villous adenoma resulting in obstructive jaundice is described.

Adenoma↗
PubMed1991

Case report: gastroduodenal intussusception--an unusual cause of pancreatitis.

Gastroduodenal intussusception is a rare complication of polypoidal gastric tumours, and it has not previously been described as a cause of acute pancreatitis. We report a case of an endoscopically, radiologically and histologically proven intussuscepting gastric leiomyoma presenting with biochemical evidence of acute pancreatitis. The radiological appearance is illustrated and possible mechanisms for the pancreatitis are discussed.

Acute Disease↗
PubMed1994

Case report: intussusception--a cause of chronic abdominal symptoms and weight loss.

A chronic clinical course for intussusception of the bowel in children is an unusual, but well recognized phenomenon. We report a case of a young child whose symptoms of vomiting and abdominal pains continued for over a month before radiological investigation made the diagnosis of ileocolic intussusception which was then successfully reduced by air enema.

Abdominal Pain↗
PubMed1976

The painless intussusception.

There were 422 cases of intussusception at the Hospital for Sick Children, Toronto, over a 12-yr period between 1959 and 1970. The histories of all patients who had no pain recorded were evaluated and the duration of signs and symptoms and the treatment required assessed. When compared with those who had pain, it was noted that the children with painless intussusception presented later, hydrostatic reduction was less likely to be effective, and operative reduction and resection was required more often.

Child↗
PubMed1986

Chronic intussusception due to antral myoepithelioma.

Intussusception was seen on abdominal sonography and computed tomography in a 15-year-old boy who presented with a 6-week history of weight loss, vomiting, abdominal pain, abdominal mass, and hyperamylasemia. Laparotomy revealed a chronic gastroduodenal intussusception, the lead point of which was an antral myoepithelioma, a rare entity in this age group.

Adolescent↗
PubMed1988

Jejunal intussusception: a case report and review.

Jejunal intussusception is a rare condition. In contrast to the typical case of ileocolic intussusception, a "lead point" is commonly found that is usually ectopic gastric mucosa. A review of the literature and a case report is presented.

Female↗
PubMed1996

Pneumatic intussusception reduction via a colostomy: case report.

Intussusception is uncommon in infants with a colostomy. The authors present the first documented case of intussusception in an infant with a colostomy in which pneumatic reduction was achieved via the stomal opening. The inflated balloon of a Foley catheter was plugged against the stoma at skin level and a tight seal was obtained. Successful reduction was achieved without any adverse effects to the patient.

Catheterization↗
PubMed1996

Recurrent intussusception: safe use of hydrostatic enema.

Recurrent intussusception (RI) occurs in 5% to 8% of patients with intussusception. The authors reviewed their 15-year experience to better define the management of RI. Among 258 patients, 28 (10.8%) had episodes of RI (37 episodes altogether). Twenty-two patients had a single recurrence, four had double recurrence, one had triple recurrence, and one had quadruple recurrence. RI and non-RI patients were compared with respect to symptoms. The incidence of vomiting and bloody stools was significantly lower in the RI group. Ten percent of RI patients had lead points. Thirty percent of RI episodes occurred within 24 hours, and 74% occurred within 6 months. The success rate of hydrostatic enema reduction for recurrent episodes was 62.8%, which is comparable to that for the initial episode (68.9%). Among patients with previous surgery, 36.3% of enemas were successful; after previous enema reduction, 75% were successful. There was no complication related to the enema. Enema reduction is safe and has a good success rate in cases of RI, even after previous surgical reduction.

Chi-Square Distribution↗
PubMed1998

Laparoscopy in the treatment of intussusception in children.

PURPOSE: The technique and outcome of minimally invasive laparoscopic treatment of various forms of intussusception in children after ineffective attempt at conservative treatment are described. METHODS: Ninety-eight patients from 2 months to 11 years of age were analyzed. RESULTS: Suggested scheme of surgical treatment using laparoscopic technique was successful in 64 patients (65.3%), and conversion to open procedure occurred in 34 (34.7%). There was no mortality or intraoperative complications in our series. CONCLUSION: Practically every form of intussusception without bowel necrosis, including the most complex forms, can be reduced now using modern videolaparoscopic equipment and atraumatic instruments.

Cecal Diseases↗
PubMed1993

Infant feeding and idiopathic intussusception.

A case-control study showed that, compared with infants who had never been fed human milk, breast-fed infants had a relative risk of intussusception of 6.0 (95% confidence interval, 1.8 to 20.4) when breast-feeding at admission was exclusive and of 2.3 (95% confidence interval, 0.8 to 6.6) when it was partial. Exclusive breast-feeding may be a risk factor for intussusception in infancy.

Bottle Feeding↗
PubMed1989

Small bowel intussusception: an unusual complication of retroperitoneal lymph node dissection.

Modified bilateral retroperitoneal lymph node dissection is used widely in the staging and treatment of patients with nonseminomatous germ cell testis tumors. Complications are uncommon and include vascular injury, infertility and small bowel obstruction from fibrous adhesions. Small bowel intussusception following retroperitoneal lymph node dissection has not been reported previously. We report 2 cases of small bowel intussusception after retroperitoneal lymph node dissection, and discuss the etiology and possible preventive measures.

Adult↗
PubMed1980

Postoperative intussusception.

When an apparently favorable postoperative course is suddenly complicated by intestinal obstruction intussusception must be considered as the most likely cause. Four cases of intussusception after genitourinary operations are presented.

Child, Preschool↗
PubMed1996

Ileal-ileal intussusception: an unusual complication following enterocystoplasty.

Postoperative ileal-ileal intussusception is an unusual and uncommonly cited complication of bladder augmentation. The preoperative diagnosis is difficult due to the vague clinical findings. We report a case of ileal-ileal intussusception that occurred following gastrocystoplasty in a child. Computed tomography accurately diagnosed the condition preoperatively, and led to early exploratory laparotomy and successful reduction.

Child, Preschool↗