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Treatment of intussusception in children operative treatment versus hydrostatic reduction.

Intestinal intussusception is a serious abdominal emergency in infancy and childhood, with a high mortality-rate if not diagnosed and treated early. Since the management of intussusception in children is still controversial, the pro's and con's for barium enema reduction and for surgical treatment are discussed. The results of our own series of 19 patients primarily treated by barium-enema reduction compare favourably with a previous series of 14 patients treated by primary surgery.

Barium Sulfate↗

Systemic lupus erythematosus with intussusception: a case report.

A 19-year-old male with systemic lupus erythematosus, had initially presented three years previous by malar rash and nephritis. In the past 2 weeks, he experienced bloody diarrhea and lower abdominal pain. Intussusceptions of the distal to the terminal ileum, terminal ileum to cecum and cecum to ascending colon were proved via exploratory laparotomy. Mesenteric lymphadenopathy was thought to be the leading cause. This is the second case of systemic lupus erythematosus with intussusception described in the literature.

Adult↗

Burkitt's lymphoma with intussusception mimicking a colonic polyp.

A 2-year-7-month old boy, presented with painless bloody stool was initially found to have an ulcerative, wide-based polyp in the ascending colon near the ileocecal region by colonoscopy. He received operation due to subsequent intussusception. Pathologic examination revealed an unusual case of polypoid Burkitt's lymphoma. The patient lives well 20 months later after receiving a standard chemotherapy. This case reminds us that colonic polyp and intussusception which is caused by Burkitt's lymphoma should be included in the differential diagnosis for a "wide-based polypoid" mass in the ascending colon.

Burkitt Lymphoma↗

Inflammatory fibroid polyp of the jejunum causing intussusception.

Inflammatory fibroid polyp of jejunum is a very rare nonneoplastic lesion of gastrointestinal tract. We reported a 66-year-old male who presented with abdominal fullness, colicky pain, and vomiting for 4 days. Plain abdomen showed intestinal obstruction with dilated small bowel loops. The exploratory laparotomy was performed under the clinical impression of intussusception caused by small bowel tumor. The diagnosis of an inflammatory fibroid polyp causing jejunojejunal intussusception was confirmed after surgery.

Aged↗

[Intestinal intussusception in pregnancy with obstruction, caused by benign neurilemmoma. Role of abdominal echocardiography in the preoperative diagnosis].

A rare case of intestinalm obstruction caused by intussusception of the small bowel due to an intraparietal benign neurilemmoma (synonym: benign schwannoma) in a patient 35th weeks pregnant is reported. It is assumed that intestinal intussusception during pregnancy is a rare complication and the diagnosis is made difficult due to the pregnancy itself, delaying the onset of symptoms and treatment. The echography was the determining factor for the diagnosis. The conclusion is drawn that surgical operation, associated or not with the cesarean section, should be carried out as quickly as possible in order to reduce the mortality rate both maternal and fetal.

Adult↗

Adult intussusception. A case report.

The intussusception in adults is very rare. Symptoms are atypic and diagnosis is difficult. We present the case of an 85-year-old female admitted for vague intermittent diffuse abdominal pain since 3 months, with episode of diarrhoea. A mobile mass was palpable in the right iliac fossa. The barium transit demonstrated a filiform stenosis of the last segment of ileum in the caecum. Scanner showed a "target mass". An ileal intussusception on caecal tumour was suggested and confirmed by laparotomy. This entity is confronted with the literature reports. The aetiology, clinical presentation, diagnosis and treatment are discussed.

Adenocarcinoma↗

Multiple intussusceptions in a juvenile rhea (Rhea americana) with proventricular impaction.

Multiple intussusceptions of the small intestine were identified in a 4-mo-old rhea (Rhea americana) that died acutely after chronically poor growth. The chick was one of a group of 12 chicks that exhibited musculoskeletal deformities, poor growth, and subsequent death. Gross necropsy findings of this chick revealed proventricular impaction by sticks and stones accompanied by multiple intussusceptions of the small intestine. This finding identifies a disease process that may afflict ratites when raised for production and that may complicate treatment of proventricular impaction.

Abnormalities, Multiple↗

Solitary ileal lipoma presenting with ileocolic intussusception: an unusual cause of enteritis cystica profunda.

We report a 63-year-old man who presented with a history of intermittent vague abdominal pain, diarrhea, and weight loss. Colonofibroscopic examination disclosed an ileocolic intussusception with a polypoid tumor on the leading edge of the intussusception. Both double contrast barium enema and computerized tomography of the abdomen confirmed this finding. The excised specimen had an ulcerated ileal lipoma with enteritis cystica profunda on the overlying epithelium.

Cysts↗

Pattern of intussusception at Gondar, Ethiopia.

Thirty three intussusception cases operated at the Gondar College of Medical Sciences hospital are presented. Thirteen of them were infants and the rest older children and adults. Clinical presentation, preoperative management, type of intussusception, cause, surgical procedures, and outcome are analysed.

Adult↗

Intussusception of the appendix caused by an adenovillous papilloma.

A case of intussusception of the appendix caused by an adenovillous papilloma in the appendix is reported. The condition was combined with acute appendicitis. The different clinical pictures are described. Due to the varied symptoms the diagnosis of intussusception of the appendix is rarely made preoperatively. The aetiology is briefly discussed. The treatment is operative with removal of the appendix or an appropriate resection.

Acute Disease↗

[Endoscopic diagnosis of an ileocolic intussusception in an adult].

Although intussusception is the most frequent cause of intestinal obstruction in children, it only represents 5-10% of all adults. The preoperative diagnosis is difficult and it is rarely done by endoscopy. We present a case of adult ileocolic intussusception caused by an ileon terminal hamartoma. The diagnosis was done by colonoscopy.

Adult↗

Small bowel intussusception and laparoscopy.

Adult intussusception is rare and is usually caused by a tumor serving as a lead point. Surgery is necessary to treat obstruction and rule out malignancy. However, if a benign cause (lipoma, fibroma, or Meckel's diverticulum) is suspected preoperatively, a minimally invasive surgical approach should be considered. This case illustrates the laparoscopic management of benign small bowel intussusception due to lipoma.

Adult↗

Gastroesophageal intussusception in a Labrador retriever.

A 14-month-old, intact male Labrador retriever was referred for evaluation of vomiting and regurgitation. A diagnosis of gastroesophageal intussusception with aspiration pneumonia was made. The patient responded favorably to aggressive surgical and medical management. The guarded to poor prognosis for gastroesophageal intussusception makes the successful outcome of this case unique.

Animals↗

Implementation of intussusceptive microvascular growth in the chicken chorioallantoic membrane (CAM): 1. pillar formation by folding of the capillary wall.

Intussusceptive microvascular growth is a new mode of capillary network growth originally described in the lungs of rabbits and rats. It constitutes an alternative to endothelial sprouting. The capillary network grows by insertion of new intercapillary meshes with dimensions around 1.5 microns called tissue pillars or posts. In a recent investigation, growth by intussusception was demonstrated in the chicken chorioallantoic membrane (CAM). In the present study the first of several modes of its implementation can now be presented in the CAM by in vivo video microscopy and analyses of light and electron microscopic serial sections: Cores of tissue pillars containing collagen fibrils ensheathed by extensions of endothelial-like cells will form within the tips of vertically running tissue folds that project into the capillary lumen. Due to retraction of tissue toward the intercapillary space the fold is thinning. Finally, the pillar's core is connected to its fold by a very slender extension of a single endothelial cell. Cell membrane fusion within that slender membrane-like structure causes subsequent separation of the pillar from its fold throughout an increasing vertical distance. This mechanism allows for expansion of the capillary network into the surrounding tissue, leaving behind tissue pillars as remnants of folds.

Allantois↗

Evidence for intussusceptive capillary growth in the chicken chorio-allantoic membrane (CAM).

The aim of our investigations was to test whether the chicken chorio-allantoic membrane (CAM) could be an adequate in vivo model for a new mode of capillary growth, originally described in the rat lung and termed intussusceptive microvascular growth. According to that concept the capillary system does not grow by sprouting of vessels, but expands by insertion of transcapillary tissue pillars or posts which form new intercapillary meshes. In the present study, we observed slender transcapillary tissue pillars with diameters around 1 microns in the CAM by in vivo microscopy, and analyzed their ultrastructure by transmission electron microscopic investigation of serial sections. The pillars corresponded in size to those previously described in rat lung microvasculature. On day 7, the pillar core contained endothelial-, endothelial-like cells and collagen fibers, and on day 12 additionally chorionic epithelial cells. As a hypothesis we propose that slender cytoplasmic extensions of endothelial cells, heavily interdigitated in the post area and often projecting into the vascular lumen, could initiate the first step of pillar formation, i.e., interconnect opposite capillary walls. During both stages of development endothelial-like cells were observed in close relationship with the pillars. These cells seem to be relevant for tissue post completion and growth, as they were found to invade the core of the pillars. From the localization of the interendothelial junctions in the post region, a certain similarity to the concept proposed for the lung can be found. The observations confirm that the CAM is a very suitable material for the in vivo investigation of intussusceptive capillary growth.

Allantois↗

Myoepithelial hamartoma of the ileum causing intussusception in an infant

Intussusception is a relatively common pediatric gastrointestinal emergency, although the etiology in most cases remains unknown. In a small number of cases the lead point is a tumor or tumor-like lesion of the small bowel. We report an unusual case of a myoepithelial hamartoma of the ileum causing an intussusception in a 4-month-old boy. This is the second such report in the literature.

Journal Article↗

"Bell-shaped ureter," a radiographic sign of antegrade intussusception.

A unique case of a hitherto unreported antegrade intussusception of the ureter secondary to a lead pedunculated polypoid transitional cell tumor is presented. Radiological documentation and surgical verification are illustrated. An attempted explanation of the peculiar radiographic appearance proximal to and within the intussusception is given. The potential aid in preoperative recognition of such an entity is proposed.

Aged↗

[Chronic circumferential aortic dissection with intimo-intimal intussusception].

A circumferential aortic dissection with so-called intimo-intimal intussusception is a very rare complication of a dissecting aneurysm, in which the sock-like intimal flap is upended in the true lumen by the blood stream. The few cases reported thus far are based on radiological or intraoperative findings in acute dissections. The present postmortem study documents the very rare case of long-term survival of a chronic circumferential dissection with intimo-intimal intussusception.

Aortic Dissection↗