Double intussusception of the small bowel through a patent vitello-intestinal duct.
A case of double intussusception through a patent vitello-intestinal duct is reported. The rarity of this condition is the reason for this short report.
Humans↗
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Retrograde jejunogastric intussusception: report of 2 cases.
Two clinical variants of jejunogastric intussusception are described. In one, self-reduction is the rule, whilst in the other strangulation occurs and emergency surgery is mandatory. A case illustrating each variant is presented and its diagnosis and treatment are discussed.
Female↗
The management of childhood intussusception in a district hospital.
Fifteen out of 34 infants with intussusception admitted to a district hospital were found to require resection of gangrenous bowel or an anatomical lead point. This resection rate (44 per cent) is considerably higher than those reported from specialist centres which rely on hydrostatic reduction as their primary form of treatment. The difference is probably a reflection of the greater proportion of late cases seen in a district hospital. Complications were virtually confined to those children who had undergone resection and it is concluded that earlier referral to hospital is the single factor most likely to reduce morbidity. Operative management is advocated, although barium enema is a safe valuable adjunct to surgery.
Barium Sulfate↗
Intussusception: a study of its surgical management.
Seventy-seven consecutive records of patients with intussusception presenting to the Royal Aberdeen Children's Hospital have been reviewed. The clinical features of the disease, the methods and the results of treatment are described. An attempt has been made to correlate clinical findings with the use, success and safety of operative intervention. Retrospectively, over 40 per cent of the cases possibly justified surgical intervention, but 10 per cent of those operated on had complications. There were no deaths in this series.
Child, Preschool↗
Intussusception due to inflammatory fibroid polyps of the ileum: a report of 12 cases from Africa.
Eleven cases of inflammatory fibroid polyp of the ileum from Malawi and 1 from Sierra Leone are described. All 12 patients presented with acute intestinal obstruction as a result of an intussusception caused by the polyp. The lesions are characterized by a variable proliferation of fibroblasts and small vessels which may involve the whole thickness of the bowel wall. Tissue mast cells and eosinophils were noted in the polyps. The aetiology of these lesions remains obscure but they appear to be reactive rather than neoplastic. The condition appears to occur more commonly in Malawi than in the United Kingdom or North America and is an important cause of small bowel obstruction in that part of Africa.
Adult↗
Intussusception: analysis of 98 cases.
A retrospective study of the clinical features and surgical management of 98 cases of paediatric intussusception treated in New Zealand during the past 16 years is presented. The classic triad of vomiting, rectal bleeding and abdominal pain occurred in only 20 percent of patients. Barium enema examination was used in 67 patients but successful reduction was achieved in only 13. Laparotomy was performed in 85 patients with 1 operative death. Gangrenous bowel was found in 17 patients and 24 required bowel resection with no associated mortality. This high rate of bowel resection appears to be related to the long duration of symptoms before the diagnosis was established. It is concluded that earlier diagnosis is the single factor most likely to reduce morbidity.
Barium Sulfate↗
Evacuation proctography in obstructed defaecation and rectal intussusception.
The symptoms of obstructed defaecation may present as a number of different syndromes including descending perineum, solitary rectal ulcer, irritable bowel and mucosal or complete rectal prolapse. In order to clarify the pathophysiology of obstructed defaecation we carried out dynamic and static radiological investigations together with manometric and electrophysiological measurements in ten patients with severe, intractable obstructed defaecation. Results were compared with a total of 35 control subjects. There were no significant differences in sphincter pressures or the recto-anal inhibitory reflex between patients and controls. Mean motor unit potential duration was prolonged in patients compared with controls (P less than 0.02) in the puborectalis and external sphincter indicative of neuropathic changes. X-ray measurements of the anorectal angle and perineal descent at rest showed no differences. However, obstructed defaecation patients had a greater increase in anorectal angle on straining (P less than 0.02) and significantly more descent on straining (P less than 0.002). Fast film sequence evacuation proctography showed that the anal canal was occluded by anterior rectal wall in four patients and five patients had variants of recto-rectal intussusception without overt rectal prolapse, which explained the obstructive symptoms. This information should allow the surgeon to follow a rational treatment programme based on the anatomical abnormality.
Adult↗
Ileocolic intussusception--a case report.
The ultrasonic findings of a case of ileocolic intussusception are presented. The clinical findings usually seen in this condition are reviewed. The atypical presenting symptoms of adult forms of this condition are emphasized.
Aged↗
The ultrasonic findings in intussusception of the blind loop in a jejunoileal bypass for obesity.
A 34 year old woman with bowel bypass surgery and persistent abdominal pain had intussusception of the blind loop, which was visualized on an abdominal ultrasound examination. The ultransonic and radiographic findings are compared and presented. Ultrasound should prove to be an invaluable tool in evaluating abdominal pain in bowel bypass patients.
Adult↗
A one-year virological survey of acute intussusception in childhood.
A prospective study was carried out during 1 year in order to correlate intussusceptions in childhood with a viral infection. A virus was incriminated in 50% of the 64 patients in this survey. Adenovirus infections remain predominant as compared to rotavirus infections.
Adenoviridae Infections↗
Peritoneal fluid in children with intussusception: its sonographic detection and relationship to successful reduction.
A retrospective review of the abdominal/pelvic ultrasound (US) examinations in 21 consecutive children with intussusception proven on barium enema was performed to determine what is the incidence of US detected peritoneal fluid in this population and to see if the rate of reduction was different in this subset. Twelve of the 21 children (57%) had free fluid demonstrated with US. Eight of these 12 (67%) had successful reduction. Six of the nine children (67%) without free fluid were also successfully reduced.
Ascitic Fluid↗
Retrograde jejunogastric intussusception: is endoscopic or surgical management more appropriate?
Jejunogastric intussusception (JGI) is a rare complication which can develop after partial gastrectomy, gastroenteroanastomosis or enteroanastomosis. Although its management is usually surgical, an endoscopic reduction can alternatively be attempted. We present herein a case of acute JGI in which failure of endoscopic reduction required surgical resection and reconstruction. This is followed by a discussion based on the current available literature.
Aged↗
Ileo-ileal intussusception in the newborn. Report of a radiologically diagnosed case.
Ileo-Ileal intussusception was demonstrated preoperatively in a newborn infant by gastrografin enema with deliberate reflux of the contrast material into the small bowel. An intraluminal filling defect and stretching of the mucosal folds were demonstrated. The indications and proper use of contrast enemas are discussed.
Female↗
Childhood intussusception: hydrostatic reducibility and incidence of leading points in different age groups.
A series consisting of 658 radiologically diagnosed intussusceptions is analysed. Hydrostatic reduction was successful in 85.2% of cases, the incidence of failure amounting to 14.8%. Analysis demonstrated a marked difference in reduction rate in different age groups. The lowest rate of success was recorded in children over 5 years of age, the group with the highest incidence of leading points. The next lowest rate of success was in those below age 1 year where the frequency of failure was more than 50% higher than in the ages between 1 and 5 years. However, the rate of leading points was approximately the same in both the latter groups and close to the average in entire series. There is no reason to refrain from barium enema reduction in any age group although special care should be exercised in the neonate. With a reasonable experience of method, the risk of overlooking a surgically significant lesion is negligible.
Age Factors↗
Intussusception of sigmoid colon in an adult. Spontaneous expulsion of sequestered bowel and restoration of bowel continuity.
A 67-year-old white man presented with bloody diarrhea and passed a 22-cm long segment of full-thickness sigmoid colon following a barium enema. He had advanced peripheral and cerebral vascular disease and had undergone pelvic irradiation for a bladder cancer five years previously. He recovered uneventfully from the bowel sloughage. This was apparently due to an intussusception of the sigmoid colon followed by the formation of adhesions between the edges of the adjacent viable bowel.
Aged↗
Small ileal neurofibroma causing intussusception in a non-neurofibromatosis patient.
Neurofibromas in the small intestine are usually accompanied by von Recklinghausen's disease (neurofibromatosis), and usually originate in the intramuscular plexus of Auerbach. We present here a solitary neurofibroma, which caused an ileocolic intussusception, originating in the submucosal plexus of Meissner in a non-neurofibromatosis patient. To our knowledge, there is no previous report of a neurofibroma originating in the plexus of Meissner. This condition was clearly confirmed by macroscopic and microscopic evaluation.
Adult↗
Pseudotumoral cecum after hydrostatic reduction of intussusception.
The authors report two cases of intestinal intussusception successfully reduced by hydrostatic pressure. A post-reduction filling defect in the cecum disappeared spontaneously on follow-up barium enema, and is therefore consistent with cecal edema. It appears an initial period of close observation for such cases is worthwhile, delaying the decision about surgery until after a follow-up barium enema; this may confirm the disappearance of the filling defect.
Barium Sulfate↗
Effectiveness of pneumatic reduction of ileocolic intussusception in children.
A total of 158 consecutive therapeutic air enemas were performed upon 133 patients during a 2-year period. Perforation and/or an impairment of the general condition of the children were the only main contraindications for the reduction attempt (five patients). Successful reductions were achieved in 89% of cases with no complications. Operation was performed in all 17 cases of unsuccessful reduction: resection in four cases, easy manual reduction in nine, difficult manual reduction in two, and spontaneous reduction in two. There were 16 (12%) patients with one or more recurrent episodes. In 23 (16%) cases, following pneumatic reduction, a swollen ileocecal valve showing a multiple appearance was observed. This fact sometimes results in a differential diagnosis with incomplete reduction; in all these cases, small bowel aeration was always a sign of complete reduction. No significant difference was noted between a swollen ileocecal valve and patient age, duration of symptoms, presence of small bowel obstruction, and further recurrences. Air enema has improved our previous success obtained with hydrostatic reduction (79%), as well as being a simpler, cleaner, and faster technique for intussusception reduction in children.
Air↗