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We report a case of a 47-year-old woman presenting with small bowel obstruction due to intussusception of an inflammatory fibroid polyp. A review of the literature describes the clinical and pathological features.
A technique for resection of irreducible, gangrenous jejunogastric intussusception is presented. In comparison with previously described resection procedures involving division of the stoma, dismantling of the gastrojejunostomy or higher gastrectomy, in situ resection is simple and safe.
In contrast to childhood, idiopathic intussusception in adults is quite rate. We report on the diagnosis (conventional plain x-ray films, sonography, coloscopy, enema) of a clinically atypical colo-colic invagination in a 29-year old woman. Since no tumour-related cause was found, disinvagination by a water-soluble contrast enema material was successfully performed.
Traditionally considered the revealing sign of an organic lesion in adults, intestinal intussusception has been reported to be generally idiopathic in African series. The authors analyze 8 cases in adults, of which 6 were idiopathic. Intestinal resection was required in 7 of 8 cases. Mortality was 25%, and linked to intestinal necrosis.
Intussusception is a serious condition. It is necessary to establish the diagnosis as soon as possible. This is of importance for the kind of therapy. We confirmed this statement by studying retrospectively 34 patients in the Emma Kinderziekenhuis in Amsterdam. There are two well known forms of therapy: hydrostatic reduction and surgery. Besides we like to pay attention to the method of air-pressure enema reduction which has been used in China for over 23 years.
Ten young horses with signs of simple partial obstruction of the small intestine were found upon surgical exploration of the abdomen to have chronic intussusception of the distal ileum into the cecum. Poor general physical condition, intermittent or continual abdominal pain of varying degree, depression, and poor appetite were consistent clinical findings. Rectal palpation in eight animals was suggestive of an incomplete or intermittent obstruction of the small intestine. Laboratory determinations were not helpful in making a diagnosis. Dilatation and hypertrophy of the distal jejunum and ileum were associated surgical findings indicating chronicity of the problem. Surgical correction utilizing an end-to-side or a side-to-side anastomosis of small intestine to cecum resulted in recovery in 7 of 8 cases which could be followed long term. Failure to resect the abnormal segment of small intestine did not affect the outcome.
A case of choriocarcinoma presenting as an ileo-ileal intussusception in a sixteen year old girl is presented. Review of the literature reveals this to be the second case ever reported with such an unusual presentation of choriocarcinoma.
Spontaneous retrograde intussusception causing obstruction is rare. We describe the radiographic and sonographic appearances, which should have been sufficient for preoperative diagnosis, in one patient.
Visceral Kaposi's sarcoma is a common manifestation of the acquired immune deficiency syndrome (AIDS). Most lesions are clinically silent, detected only by radiographic or endoscopic studies. We report the first instance of AIDS-related jejunal Kaposi's sarcoma presenting with small intestinal obstruction due to intussusception. Gastrointestinal Kaposi's sarcoma is a clinical problem that may occur more frequently in the future.
A case is reported in which a surgical gastrostomy tube migrated into the duodenum and eroded through the jejunal wall into an adjacent loop of jejunum. This resulted in an entero-enteric fistula, small bowel obstruction and intussusception. Since the number of gastrostomy tubes being placed endoscopically and surgically is increasing, gastroenterologists and surgeons should be alerted to these and other potential complications.
Ultrasound examination is at present a subsidiary aid in the definition of bowel lesions. There are, however, echographic features suggestive or diagnostic of intussusception. These should be borne in mind during ultrasound examination of the patient with a tender abdominal mass or intermittent diffuse abdominal pain.
Intestinal intussusceptions in 2 young dogs recurred within 3 days of initial surgical reduction. Subsequent recurrence was prevented by intestinal resection and creation of multiple intestinal adhesions in 1 dog and by creation of adhesions alone in the other.
The spontaneous expulsion of lipoma per rectum is an extremely rare phenomenon. The present case report describes this event in a patient with lower abdominal pain and bleeding per rectum leading to exploratory laparotomy. At surgery, a large intussuscepting ulcerated submucosal lipoma remnant was identified in the transverse colon. This unusual presentation of colonic lipoma is discussed and the pertinent literature is reviewed.
The hospital records of 111 children aged 2 to 15 years who were treated for intussusception between mid-1974 and mid-1984 were reviewed. Severe intermittent abdominal pain was the most consistent, and frequently the only, clinical feature. Hydrostatic reduction was almost as successful as in children under 2 years of age, and its success was independent of the duration of symptoms. Most cases were idiopathic, but lead points were common in children 6 years of age or older. There was an unexpectedly high recurrence rate, 20%. In all three children with lymphoma the signs and symptoms were clearly atypical and were suggestive of pre-existing disease. In the absence of suspicious clinical or radiologic findings, laparotomy to rule out lymphoma is not warranted.
Ultrasound imaging findings of the invaginated bud are described in 60 young children referred with a suspected acute intestinal intussusception over a period of 5 months. An initial group of 28 children were examined by ultrasonography and a barium enema for diagnostic and possible therapeutic purposes. The second series of 32 children were a therapeutic enema only when ultrasound images provided a positive diagnosis. The method is considered to be a reliable one requiring less medication, and has the principal advantage of suppression of the need for diagnostic barium enema.
An excessively long ileal stump, the result of a previous jejunocecostomy, had intussuscepted into the cecum and subsequently obstructed the cecocolic orifice of a 12-year-old Quarter Horse mare. Clinical signs were dehydration, ileus, and endotoxemia. The diagnosis was made at necropsy.
A case of gastroduodenal intussusception due to the prolaps of a gastric adenoma is presented. The radiographic findings are discussed and illustrated. The clinical features and therapy are briefly dealt with.
The difference in presentation between two different social groups of children with intussusception was investigated. The sex ratio of the two groups was different. The underprivileged children presented later in the disease and consequently required bowel resection more frequently. The introduction of intravenously administered ketamine increased the barium reduction rate significantly.