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PubMed2000

Intussusceptive microvascular growth in the lung of larval Xenopus laevis Daudin: a light microscope, transmission electron microscope and SEM study of microvascular corrosion casts.

The remodeling of the uniform wide, plexus-like capillary bed of the lung of metamorphosing tadpoles of the South African clawed toad Xenopus laevis (Daudin) is studied from developmental stages 54 to 65 by scanning electron microscopy (SEM) of microvascular corrosion casts (VCCs), light microscopy (LM) and transmission electron microscopy (TEM). VCCs reveal that the remodeling of the existing uniform, plexus-like lung capillary bed into well-defined alveolar capillary meshworks starts in the caudal lung and then gradually proceeds cranially. Vascular remodeling is entirely by intussusceptive microvascular growth through insertion and enlargement of new and fusion of pre-existing capillary meshes. Analyses of lung tissue serial sections at the LM and TEM level confirm the presence of intracapillary cushions and tissue posts and correlate these structures in respect of size and location to the round to slit-like imprints and tiny "holes" found in VCCs. Additionally, SEM of VCCs give clear evidence that intussusceptive microvascular growth is also involved in the remodeling and maturation of alveolar arterioles and venules.

Animals↗

PubMed1985

Intussusception technique for use in duplicated system.

Removing a ureter by intussuscepting it into the bladder has been described previously; but so far use of this technique was thought to be contraindicated in the presence of a duplicated system. We have modified this technique so that intussusception can now be used in a duplicated system as well. Two cases are presented.

Female↗

PubMed2006

Intimo-intimal intussusception of the aorta.

A 50-year-old man presented with acute onset of chest pain. Subsequent transesophageal echocardiography and computed tomography scan showed absence of a flap in the ascending aorta and a clear dissection flap involving the arch and descending aorta. Magnetic resonance imaging showed a tear and a small flap in the right coronary sinus. During surgery, we found a total circumferential intimal tear at the sinotubular junction with intimo-intimal intussusception of the internal channel into the arch. Dissection without intimal flap and aortic intussusception is a rare form of type A dissection, which is difficult to diagnose on routine investigations and can delay treatment.

Aortic Dissection↗

PubMed2004

Antegrade ureteral intussusception: a rare complication of percutaneous endopyelotomy.

Ureter intussusception is a rarely reported event and is usually secondary to a ureteral lesion. We report a case of a 15-year-old boy developing antegrade ureteral intussusception secondary to percutaneous endopyelotomy performed for pelvicaliceal junction obstruction. The most appropriate treatment is likely to be surgical excision coupled with pyeloplasty reconstruction or nephrectomy if renal function is beyond salvage. To our knowledge, this has never been reported, and we believe that awareness of this complication should be made known to urologists.

Adolescent↗

PubMed1996

The intussusception antireflux valve is ineffective in preventing cholangitis in biliary atresia.

Cholangitis is the most common complication after portoenterostomy for biliary atresia. The construction of an intussusception valve in the Roux-en-Y limb of the portoenterostomy has been advocated as a means to ameliorate this complication. The authors reviewed the records of children who underwent portoenterostomy to assess the incidence and severity of cholangitis, as well as outcome. The children were divided into two groups according to whether they did not have (group I) or did have (group II) an antireflux valve in the Roux limb of the bilioenteric conduit. There were 19 children in each group. There were no significant differences between the groups with respect to age at time of portoenterostomy or length of follow-up (Table 1). Nine group I patients are alive and well; five died and five have had or are awaiting transplantation. In group II, 10 patients are alive and well, eight have had transplantation, and one is awaiting transplantation. Outcome with respect to death or the need for liver transplantation because of progressive hepatic failure is not different between the groups (P = 1.0, Fisher's 2 x 2). The incidence of cholangitis was evaluated by comparing the average number of episodes of cholangitis during the follow-up period, the number of episodes per year, and the number of episodes in the first postoperative year (when this complication is most prevalent). Analysis of the data showed no difference in incidence between those with valved and nonvalved biliary conduits. The severity of cholangitis, judged by total length of antibiotic treatment, did not differ between the groups. It appears that the presence of an intussusception valve in the Roux-en-Y biliary conduit does not affect the incidence of cholangitis or the outcome after portoenterostomy, over short-term follow-up.

Anastomosis, Roux-en-Y↗

PubMed2003

Intimo-intimal intussusception: a rare clinical form of aortic dissection.

A 33-year-old hypertensive man presented with epigastric pain radiating to the back. Transoesophageal echocardiography (TOE) revealed an intimal flap on the aortic arch and descending aorta. No intimal flap of the ascending aorta was detected on TOE or CT. The diagnosis was made on opening the ascending aorta: complete circumferential dissection of the ascending aorta flush with the coronary ostia, with no residual intimal flap, and intimo-intimal glove-finger intussusception of the internal channel into the descending thoracic aorta. Aortic intussusception is a very rare form of Type I dissection, and the absence of intimal tear in the ascending aorta can be misleading and delay the diagnosis.

Adult↗

PubMed2002

A modified intussuscepted nipple in the Kock pouch urinary diversion: assessment of perioperative complications and functional results.

OBJECTIVE: To assess the complications and continence of a modified intussuscepted nipple in Kock pouch urinary diversions. PATIENTS AND METHODS: From February 1992 to December 2000, 40 patients (mean age 55.8 years, range 21-74) with bladder cancer (24), gynaecological tumours (eight) or previous lower tract reconstructive surgery (eight) underwent cystectomy and cutaneous continent urinary diversion using the Kock pouch procedure. The first 23 procedures (group I) used Henriet's technique, whereas a modified fixation of the intussuscepted efferent limb was applied in the last 17 (group II). Complications and functional results (focused on continence and the upper urinary tract) were reviewed. RESULTS: The median (range) follow-up was 47.6 (10-124) months; one patient died 4 weeks after surgery. Early complications occurred in 11 (28%) and re-operation was required in two (5%). Of the late complications reported (38%), extussusception (8%) and efferent nipple prolapse (3%) only occurred in group I and required surgical revision. Late complications were minor (15%) including two asymptomatic refluxes and four with stoma sclerosis. The continence rate at 6 months in groups I and II were 78% and 94%, respectively (P = 0.13). CONCLUSION: Efferent limb prolapse and extussusception of the Kock pouch were the main complications requiring surgical revision. Applying the modified nipple fixation the complications can be reduced and reservoir continence improved.

Adult↗

PubMed2003

Intussusceptive capillary growth is required for glomerular repair in rat Thy-1.1 nephritis.

BACKGROUND: Injection of anti-Thy-1.1 antibodies to rats causes mesangiolysis, with subsequent capillary loss. This dramatic event is followed by almost complete recovery of glomerular architecture. However, the precise cellular mechanisms of revascularization are not fully understood. METHODS: Glomerulonephritis was induced by the injection of monoclonal anti-Thy-1.1 antibody to rats. Structural changes in the glomerular vasculature, with special emphasis on the repair phase, were studied with corrosion casting technique, light microscopy (LM), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). RESULTS: Specifically during the extensive revascularization period, numerous tiny holes of about 1.5 microm in diameter were found on the glomerular cast. The presence of transluminal tissue pillar was confirmed with LM and SEM. These findings indicate the involvement of intussusceptive capillary growth. TEM study demonstrated that some tissue pillars were composed of endothelial cells only and others had cytoplasmic process of mesangial cells in their cores sandwiched both sides by endothelial walls. CONCLUSION: Intussusceptive capillary growth, or nonsprouting angiogenesis is involved in the postinjury angiogenesis in the glomeruli, in which process mesangial cells as well as endothelial cells may play important roles.

Animals↗

PubMed1991

Short intussusception valves prevent reflux after jejunal interposition bilioduodenal anastomosis.

Short whole circumference and semi-circumference intussusception valves were created in interposition cholecysto-jejunal-duodenal conduits in pigs to determine which method best prevented gastrointestinal reflux into the biliary tract. Following intravenous injection of 99 mTc-HIDA the time interval for its excretion from the liver and appearance in the duodenum was not different in either whole or semi-circumference valve animals or in controls without valves. After intragastric administration of 99 mTc-DTPA the relative radioactivity of gallbladder contents (reflux) in the cohort without valves was significantly higher than in both cohorts with valves. Animals with semi-circumferential valves in turn had significantly higher levels of nuclide than those with whole circumference valves. Reflux was observed grossly in 100% of animals without valves, in 20% of those with semi-circumference valves, and in no animals with whole circumference valves. This study indicates that both whole and semi-circumference intussusception valves placed in jejunal biliary conduits allow unimpeded flow of bile into the gastrointestinal tract. Whole circumference valves are more effective for prevention of reflux than semi-circumferential valves.

Animals↗

PubMed2006

A case of an intussuscepted neuroendocrine carcinoma of the appendix.

We have described a previously unreported entity of an intussuscepted neuroendocrine carcinoma of the appendix. Our patient was a 70-year-old man whose only complaint was insipient weight loss. Colonoscopy showed a malignant cecal "polyp", and an extended right hemicolectomy was performed. We have reviewed the literature on the causes of appendiceal intussusception and their appropriate treatment options, and clarified the classification of neuroendocrine tumors of the gastrointestinal tract.

Aged↗

PubMedDate not supplied

[SMALL BOWELL LIPOMA CAUSING INTUSSUSCEPTION IN AN ADULT]

Primary or metastatic neoplasms of the small bowel are rare. The most common cause of intestinal intussusceptionin adults are tumors of the small bowel. The intraluminal lesion alters the normal peristalsis of the intestine and permits the displacement of the proximal intestine to the interior of a segment of the distal intestine generally fixed. The preoperative diagnosis is difficult and computed tomography and intestinal barium are the most useful studies in order to define this entity. The management is surgical and consists in the reduction of the affected segment and the surgical resection with margin of mesentery. The prognosis correlates with the result of the histopathological study of the original tumor. The present study analyzes a case of lipoma of small bowel causing intussusception and intestinal occlusion. At laparotomy an ileocecal intussusception caused by an intraluminal tumor in the terminal ileon was evidenced, performing right hemicolectomy and end- to- end ileotransverse colostomy. The microscopic study revealed a lipoma of ileum.

Journal Article↗

PubMed2006

Small bowel intussusception: what is the role of laparoscopy?

Small bowel intussusception in adults is a rare surgical disease which almost always occurs as a complication of either benign or malignant lesion of the bowel that is working as a leading point. In adults, the surgical approach consists of the resection of the bowel involved to ensure the excision of the lesion below. The authors report a case of ileocecal intussusception occurred in a young woman, 35 years old, observed for abdominal pain and signs of small bowel occlusion. She underwent surgical resection of the ileocecal segment with laparoscopic approach. The authors discuss the feasibility of the laparoscopic approach in this rare surgical disease and its benefits in terms of patient's postoperative comfort and outcome.

Journal Article↗

PubMed1985

Intestinal intussusception valve for postgastrectomy bile reflux and/or dumping.

The short-term results of a new surgical procedure for prevention of duodenogastric reflux and rapid gastric emptying after partial gastric resection are reported. A jejunal segment provided with an intussusception valve was interposed between the gastric remnant and the duodenum in six patients with severe postgastrectomy symptoms. Duodenogastric reflux, determined with an isotope derivative method, was found to be completely eliminated after the remedial operation. Gastric emptying of a glucose solution showed no significant delay. Previous gastroscopic findings of "gastritis" could not be recognized at postoperative examination. The histologic mucosal changes showed no remission, however. No patient became completely free from gastric symptoms after the remedial operation. The residual symptoms possibly were caused by impaired emptying of the gastric remnant. Gastric mycosis was found occasionally in all the patients during follow-up. The jejunal intussusception valve effectively prevented bile reflux and seemed to have a beneficial effect on dumping symptoms.

Adult↗

PubMed1997

[An unusual complication of anterograde endopyelotomy: ureteral intussusception (a case report)].

Endopyelotomy has recently found a new place in the treatment of stenosis of the pyeloureteral junction, and it can represent a treatment of choice. We report an unusual case of antegrade ureteral intussusception after antegrade endopyelotomy in a 30 year-old young woman with a solitary kidney, which caused proximal ureteral obstruction. These intussusceptions were probably caused by double CH endoprosthesis. These iatrogenic injuries required surgical resection with calicoureterostomy.

Adult↗

PubMed1975

Intussusception in children: hydrostatic reduction.

The records of 104 patients with the diagnosis of intussusception who were admitted to the Saisei-kai Suita Hospital during the past five years were reviewed. There were no deaths. All patients were treated primarily by barium enema with a successful reduction rate of 82%. Successful reduction requires the use of general anesthesia, repetition of the procedure after a three- or five-minute waiting period, use of a balloon catheter, and manipulation. The most important points are early detection of this disease by the pediatrician and enthusiasm on the part of the surgeon.

Age Factors↗

PubMed2000

Intussusception following the Ladd procedure.

HYPOTHESIS: The Ladd procedure for malrotation predisposes children to postoperative intussusception (POI). DESIGN: Retrospective case-control review. SETTING: University-affiliated tertiary care pediatric hospital. PATIENTS: Five of 159 patients undergoing the Ladd procedure between 1995 and 1998 developed POI. Predisposing factors were sought by comparison with age-matched controls who underwent the Ladd procedure during the same period. The entire Ladd group was compared with all 1717 patients undergoing any other laparotomy during the same period for incidence of POI. MAIN OUTCOME MEASURES: Differences in weight, percentile weight, age, length of nasogastric suction, time to oral intake, and length of stay between Ladd patients developing POI and age-matched controls from the Ladd group were compared using the Mann-Whitney U test. Incidence of POI after the Ladd procedure and "other laparotomy" was compared using chi2 analysis. RESULTS: In the Ladd group, there were 5 cases of POI (3.1%). There was 1 case of POI (0.05%) after all other laparotomies (P<.001). Symptoms developed at a mean +/- SD of 7.2 +/- 2.1 days. Upper gastrointestinal tract with small bowel follow-through showed partial bowel obstruction in 4 cases and was normal in 1 case. Reexploration took place at a mean +/- SD of 9.2 +/- 2.8 days. Children developing POI after undergoing the Ladd procedure were less likely to be small for their age (P= .03) than age-matched controls undergoing the Ladd procedure. CONCLUSIONS: The Ladd procedure predisposes children to POI. Aggressive investigation, including reexploration, should not be delayed if a child has symptoms of prolonged ileus within 2 weeks after undergoing a Ladd procedure.

Case-Control Studies↗

PubMed1995

Retrograde gastroesophageal intussusception complicating chronic achalasia.

We treated a patient with retrograde gastroesophageal intussusception complicating chronic achalasia. Operation consisted of diaphragmatic division in the median plane to facilitate reduction, followed by Heller myotomy and fundoplication for the achalasia. The patient was able to eat normally after recovery.

Adult↗

PubMedDate not supplied

Sonographic diagnosis of intussusception of the appendix vermiformis.

We present 2 cases of intussusception of the appendix vermiformis (IAV) in children. Sonographic examination demonstrated a lead point within a characteristic multiconcentric ring sign, and longitudinal sonograms showed the inverted appendix protruding into the cecal lumen. A contrast-enema study, using a water-soluble contrast medium, was performed in each case, and a "coiled-spring" sign or "spiral shell" appearance confirmed the diagnosis. A surgical reduction of the appendix and an appendectomy were performed in each case.

Appendectomy↗