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Jejunogastric intussusception is an infrequently reported complication of gastroenterostomy. Prognosis and treatment are functions of the anatomic type (Shackman's classification). Gastroscopy and sometimes roentgenograms are the major diagnostic tools. Surgical treatment is required in the acute types where incarceration or strangulation occurs, and in the chronic types when function or quality of life is impaired.
We have described a case of intussusception of the defunctionalized loop of small bowel after jejunoileal bypass. This complication may be avoidable by suturing the free end of the proximal jejunum to the root of the transverse mesocolon. Diagnosis is aided by closely placing silver clips on these same structures and observing for their separation on radiographs of the abdomen.
This study is a review of all cases of intussusception from December 1971 to December 1981 at the Erlanger Medical Center in Chattanooga. Only 24 cases were found. A disproportionate number of patients were white (92%). The male to female ratio was 2 to 1. There was no regular seasonal variation. Several patients were below the third percentile in weight for their ages. The most common signs and symptoms were vomiting, pain, and bleeding per rectum. The occurrence of anatomic lead points was high, and the success rate for hydrostatic reductions was low. The use of glucagon before barium enema increased the success rate of hydrostatic reduction by 75%, from four successful reductions to seven of 20 attempts.
We report a case of rare solitary neurofibroma of the transverse colon in a patient without neurofibromatosis. The patient was found to have an intussuscepting tumor prolapsing transanally, with massive lower gastrointestinal bleeding. This case represents only the second documented report of an isolated colonic neurofibroma.
We present the case of a 29-year-old woman with an asymptomatic intussuscepted appendix found incidentally during surgical evaluation for a pelvic mass in a patient with endometriosis. This case represents the rare nature of this presentation and the need to fully evaluate the gastrointestinal tract in patients with endometriosis.
Aberrant pancreas is a congenital anomaly. In surgical series, its incidence varied from 0.2 to 0.8%. About 70% of aberrant pancreas occur in the gastrointestinal tract. Eighty percent of them locate in the stomach and duodenum, and only 0.2% in the ileum. We report on a 25-year-old woman with ileal aberrant pancreas who suffered from ileal intussusception and recurrent gastrointestinal bleeding. The diagnosis was confirmed by surgery and histology. She is symptom-free after surgery.
Gastrointestinal stromal tumors are rare tumors of the gastrointestinal tract. They, however, occur most commonly in the stomach where they present with abdominal pain, bleeding, and obstruction. Many are asymptomatic and are discovered incidentally or at postmortem. We present a case-report of a rare complication of gastrointestinal stromal tumors of the stomach causing gastroduodenal intussusception and how patient was successfully managed by laparoscopic Billroth II distal gastrectomy.
AIMS: To determine whether natural rotavirus infection or infection by another enteropathogen is associated to intussusception (IS); and to describe the seasonality of IS compared with severe diarrhea (SD) and rotavirus SD in Mexican children. METHODS: A prospective, observational, multicenter and case-control study was conducted in Mexico City from December 1999 to February 2001. Cases were children younger than 1 year old hospitalized for IS; diagnosis was made by clinical features, radiologic and/or surgery findings. Controls were children younger than 1 year old hospitalized for another disease than a gastrointestinal illness (NGI). Cases and controls were paired by age and date of admission (+/-3 months; for both), in a 1:2 ratio. A surveillance of IS cases, SD and rotavirus SD episodes was conducted during the study period. Stool samples collected soon after IS resolution or at admission were tested for rotavirus, adenovirus, astrovirus, bacteria and parasites. RESULTS: Thirty cases of IS and 60 controls with NGI were studied. Rotavirus was not detected in any case of IS. Adenovirus (17%) was the only enteropathogen detected in IS. Rotavirus (8%), adenovirus (2%), astrovirus (2%) and bacteria (2%) were detected in NGI. Rotavirus infection was not associated with IS (odds ratio, 0; 95% confidence interval, 0-2.9), whereas adenovirus infection was strongly associated as risk factor for IS (odds ratio undefined; P = 0.003), compared with NGI. Seasonal variation in admissions for IS was small, whereas admissions for SD and rotavirus SD showed a marked seasonal increase during fall-winter. CONCLUSIONS: In Mexican children, rotavirus infection was not associated to IS; whereas a significant association was observed between adenovirus and IS. Also there was no increase in IS cases during the sharply defined fall-winter rotavirus outbreak. Observations from this controlled study suggest that natural rotavirus infection is not a risk factor for IS. This information may have implications for development of a safer and effective rotavirus vaccine.
A case of jejunojejunal intussusception is presented, in which a malignant melanoma deposit acted as the lead point. The diagnosis was made on CT and the appearances are described.
A case of intussusception due to a pathological lead point in a child is presented. Such cases are uncommon in the paediatric age-group. The pathological lead point was missed at air enema reduction but it was clearly defined on sonographic-guided hydrostatic reduction. The advantages and disadvantages of these reduction methods are discussed.
Three cases of asymptomatic intussusception in adults are reported, discovered incidentally during a CT scan of the abdomen. It is being increasingly observed in adults, possibly aided by the reformatting capabilities of the new multislice CT scanners. It has been documented in children where it is considered to be transient and of no clinical significance.
An infant with intussusception who developed an unusual complication of transanal and intraperitoneal prolapse is reported. Complete venous occlusion of the intussusceptum for a prolonged period in a patient with congenital anomalous vascular supply of the colon is suggested as a mechanism responsible for rupture of the intussuscepiens.
A retrospective survey of 128 patients, representing 139 instances of proven intussusception is reviewed. An initial hydrostatic enema reduction attempt was performed in 75% of cases, with 50% of these being successful. A high recurrence rate of 18.4% followed the hydrostatically reduced cases, compared with 2.7% for the surgically treated. Hydrostatic reduction was particularly unsuccessful in infants less than six months of age, when the duration of symptoms exceeded 12 hours and when the presentation is painless. Earlier surgery is recommended for these children.
A case is reported of an ileocaecal intussusception caused by a previously recognized Meckel's diverticulum. The case offers the opportunity to discuss the management of an asymptomatic Meckel's diverticulum found incidentally. The conclusion is reached that, in general, diverticulectomy is appropriate.
The following is a case report of double intussusception of ileum through a patent vitello-intestinal duct in a 5 week old infant. This is the first case to be reported in Australia. The incidence, clinical features, diagnosis, treatment and prognosis of this condition are discussed.
A case of actue jejuno-gastric intussusception diagnosed at gastroscopy is described. The patient had undergone a Polya gastrectomy eight years previously. Other reported cases have been discovered by radiology or at surgery. Endoscopy is the method of choice to diagnose this uncommon, but important condition.
Bowel obstruction is a well-known complication of Crohn's disease and is usually a result of stricture formation. Intussusception due to giant pseudopolyps is a rare form of bowel obstruction even in Crohn's disease. These giant pseudopolyps rarely regress with medical management alone and often require surgical resection.
A case is reported of a girl born by caesarean section at 28 weeks gestation who developed an acute perforation of the ileum due to intussuspetion 11 days after birth. This was treated successfully by resection of the affected segment of ileum and by performing a temporary ileostomy followed by end-to-end anastomosis. She made a complete recovery. This case also demonstrates the difficulty of early diagnosis of intussusception in the neonatal period.