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Childhood intussusception in Benin City, Nigeria.

The clinical and radiological features of 24 cases of childhood intussusception presenting at the University of Benin Teaching Hospital are analysed. Nineteen (79%) children presented before the age of one year and the main symptoms were vomiting 87%, passage of bloody stool 62%, abdominal pain 50% and palpable abdominal mass 33%. The commonest aetiologic agent was ascariasis which was seen in three children. Radiological examination was found most useful in selecting patients for barium hydrostactic reduction, and a case is made for the use of the latter procedure in the treatment of childhood intussusception in developing countries. The high case fatality rate of 25% is related to the late presentation of children to hospital.

Adolescent↗

[Intussusception in the newborn (author's transl)].

A five day old male neonate had bloody stools and decreasing appetite. He was subjected to laparotomy after x-ray investigations had shown an intussusception. This was due to a cystic duplication of the ileum just before the ileocecal valve. After an ileocecal resection the postoperative course was uneventful. Special problems of the intussusception in the newborn are discussed.

Humans↗

Intussusception involving the spiral colon in a calf.

Clinical examination of a ten month old Holstein heifer with a history of colic and anorexia revealed a distended viscus in the midline and a hard, sausage-shaped mass in the right lower posterior quadrant of the abdomen. At surgery, the mass was exteriorized and found to be an intussusception of the colon into the spiral colon. The intussusception was reduced by traction and the animal made an uneventful recovery.

Animals↗

Adult intussusception presenting with transient intestinal ischemia.

A 71-year old woman initially presented with abdominal pain and an x-ray picture of ischemia of the terminal ileum. The ischemic changes were transient and reversed spontaneously. Six months later, she presented with the same complaint and an x-ray picture of ileocolic intussusception. At operation, a lipoma of the ileum was the leading point of the intussusception and ischemic changes of the ileum were evident.

Aged↗

[Intussusception: diagnosis and treatment with saline enema under ultrasound].

Intussusception is the most common abdominal emergency of early childhood. In the past 100 years intussusception has been treated by both surgical and nonsurgical methods. The last few years have brought improved nonsurgical methods of treatment. We present the results of ultrasonic diagnosis, and of treatment by saline enema under ultrasound, in the first 7 infants in our series.

Enema↗

Early diagnosis of adult intestinal intussusception at four different locations.

Four cases of adult intestinal intussusception at four different locations (two ileocolic type, two colocolic type involving the transverse and the rectosigmoid colon) are reported. The most beneficial diagnostic procedures were emergency contrast studies of the colon or computed tomogram of the abdomen. Three cases were associated with primary malignancy. Surgical resection without reduction is favoured because an underlying primary malignancy should be suspected in adult patients. The literature about the causes and the more recent considerations involved in the management of adult intussusception is reviewed.

Aged↗

[Gastroduodenal intussusception on gastric tumor].

Gastroduodenal intussusception is a rarely documented condition. A distinction has to be made between complete gastroduodenal intussusception (CGDI) and either prolapse of a pedunculated tumor through the pylorus or mucosal prolapse through the pylorus. CGDI usually occurs secondary to a pedunculated benign gastric tumor. More rarely the tumor is malignant. We report a case of CGDI associated with gastric adenocarcinoma. We emphasize diagnostic difficulties that can be generated by CGDI.

Adenocarcinoma↗

[Intussusception in infants].

Intussusception, the invagination of a portion of the intestine into an adjacent segment, is the most common cause of intestinal obstruction in post neonatal children. Most cases are idiopathic, but in about 2-12% the intussusception evolves secondary to an underlying abnormality. Classically, there is sudden onset of attacks of screaming, accompanied by pallor, vomiting, and irritability in a previously health child. Some gradually become weaker and lethargic. We evaluated variations in presenting symptoms and outcome as related to age and time until admission. There were incidence peaks in the spring and autumn. 48% developed irritability, while 42% were described as apathetic. These results emphasize the importance of awareness that apathy can be a major presenting symptom. The younger the child, the greater the rate of success of reduction by hydrostatic pressure. In those admitted within 24 hours of onset, the rate of reduction was twice that in those admitted later. Awareness of atypical symptoms and early diagnosis may affect treatment and improve prognosis.

Humans↗

[A cause of intestinal intussusception in an adult].

Inflammatory fibroid polyp is a very rare tumor involving the gastrointestinal tract and especially the stomach and small bowel. It presents either as a solitary pedunculated or sessile lesion arising from the submucosa. Despite its large size and sometimes very infiltrating growth, the polyp is benign and has a good prognosis. The aetiology remains unknown but it probably represents a reactive proliferation similar in many respects to the granuloma pyogenicum. We report an ileal case which presented itself as an acute intussusception. The very typical and complete sonographic and tomodensitometric findings of this intussusception are detailed. The polyp alone does not have noteworthy radiological characteristic signs and must be included in the large and essentially histological differential diagnostic of gastrointestinal tumors.

Adult↗

Villous adenoma of the vermiform appendix with cecal intussusception: a case report and review of literature.

Villous adenoma of the appendix is an uncommon neoplasm. Intussusception of the appendix is a rare pathological entity. We report here an intussusception of the appendix, the lead point being a villous adenoma, presenting in a 62-year-old male whose initial complaint was a progressive enlargement of a right inguinal hernia. The endoscopic, surgical, and pathologic data are presented. A review of the literature of this uncommon entity is also presented.

Adenoma, Villous↗

Intussusception in children: a ten year review.

Sixty six cases of intussusception were admitted to ESCH, Addis Ababa over a 10 year period. Males dominated in the series. Age distribution showed that 69.7% of the cases were < or = 1 year old, and 85% were < or = 2 years old. Abdominal pain, vomiting, bloody mucoid diarrhoea and mass palpated abdominally and/or rectally were the commonest modes of presentations. Intussusception occurred more often in well nourished children, but was rare in severely malnourished ones. An underlying intestinal pathology was found in two cases only. The mortality was high probably because the majority of cases presented late for medical attention. The need for early medical advice, diagnosis and intervention should reduce the mortality.

Abdominal Pain↗

[The National Workshop on Defecography: anorectal deformities with a functional origin (prolapse, intussusception, rectocele)].

The nonoperative treatment--i.e., rubber band ligation and sclerotherapy--of mucous rectal prolapse, rectocele and intussusception is much less expensive than conventional surgery (Lit. 325,000 vs. 6,500,000, p < 0.0001 on the average). Symptom relief, however, has been reported in 0 to 57% of cases only, according to current literature. A possible cause is represented by improper management from misdiagnosis, relying on clinical findings only, overestimating mucous prolapse in 36.37% of cases and underestimating intussusception in 14.22% of cases (with respect to defecography). Defecography is a cost-effective method (average cost: Lit. 37,000) potentially reducing failure rate after the surgical repair of rectal prolapse.

Ambulatory Surgical Procedures↗

Gastroduodenal intussusception due to Peutz-Jeghers syndrome. A case report.

An 18-year-old Chinese male was admitted to our hospital with recurrent abdominal pain, abdominal distension and intermittent non-bilious vomiting of about 2 months standing. A mildly tender mass measuring about 6 x 7 cm was present in the right upper quadrant area, and an abdominal computed tomography scan with enhancement showed a clearly encapsulated mass occupying the right side of the upper intra-abdominal area. Endoscopy revealed two huge cauliflower-like polyps and one small polyp in the stomach, and the biopsy specimens showed hyperplastic polyps. Moreover, multiple pigmentation of the buccal mucosa was also noted. The intra-abdominal mass was found to be a gastroduodenal intussusception following laparotomy. Gastroduodenal intussusception occurring secondarily to Peutz-Jegher syndrome, is a rarely documented condition. Only one case has been reported in Japan during the previous years. We report on another case, and review the literature.

Adolescent↗

Intussusception of appendix with carcinoid tumour. A case report.

During an operation for suspected appendicitis, no appendix was found at the confluence of the caecal taeniae. A mobile mass in the caecum was explored and intussusception of the appendix was identified. Histological examination of the specimen revealed carcinoid of the appendix. The diagnosis and management of intussusception of the appendix are discussed.

Adult↗

Inflammatory fibroid polyp of the jejunum causing intussusception: a case report.

Inflammatory fibroid polyp is a rare benign lesion of the gastrointestinal tract. This report concerns a 56-year-old female who presented with intermittent abdominal pain, vomiting and diarrhea; she had had partial intestinal obstruction over a period of two months. Plain abdomen showed dilatation of the small bowels. Abdominal echo revealed intussusception of the small intestine. During exploratory laparotomy a polypoid dumb-bell shaped polyp was noted as the leading point of the jejunojejunal intussusception, segmental resection of the jejunum was performed. Histological features of the polyp met the diagnosis of inflammatory fibroid polyp.

Female↗

Histopathology: its role in the diagnosis of a child with intussusception.

Spontaneous expulsion of a small portion of the intestinal mucosa per rectum, in an infant, associated with ileocolic intussusception is an extremely rare condition. This appears to be the first report of such a clinical presentation. The initial diagnosis was raised by the histopathologist following examination of the eliminated piece of tissue. Subsequent barium enema and laparotomy confirmed the diagnosis and the ileocolic intussusception was successfully reduced. This unusual presentation, together with a review of the pertinent literature, is discussed. Our findings indicate that both the clinicians and histopathologists should be aware of this phenomenon and stress the importance of the histological examination of any unusual faecal matter. This may prove to be a simple, quick and cheap method of investigation of this condition.

Colon↗

Jejunal intussusception in adult horses: 11 cases (1981-1991).

Medical records of 11 adult horses with jejunal intussusception examined at 5 veterinary teaching hospitals between 1981 and 1991 were reviewed. Nine of 11 horses had signs of acute abdominal discomfort for < 24 hours, whereas 2 horses had a history of chronic signs. Five of 11 horses had an intraluminal or intramural mass associated with the jejunal intussusception. Two horses died or were euthanatized prior to surgery. Partial jejunal resection and jejunojejunal anastomosis were performed in 9 horses. One horse died during surgery and 2 were euthanatized prior to hospital discharge because of postoperative complications. Four of the 6 horses that were discharged from the hospital survived from 16 months to 6 years and returned to their previous level of performance. One horse died 3 months after surgery from unknown causes, and 1 horse was lost to long-term follow-up evaluation.

Anastomosis, Surgical↗

Spiral colon intussusception in a three-year-old bull.

Intussusception of the spiral colon was diagnosed in a 3-year-old Charolais bull. Necropsy revealed the intussusception to involve approximately 40 cm of the first centripetal gyrus of the spiral loop, beginning 70 cm distal to the ileocolic junction. Predisposing lesions were not noticed in the mesentery or lumen of the affected intestine; however, the involved intestine was necrotic. Surgical resection of the lesion was not attempted because of the compromised nature of the involved large intestine and because of the inability to exteriorize the region in the standing animal.

Animals↗