Intussusception in adults: Clinical characteristics, diagnosis and operative strategies (original) (raw)
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Intussusception in adults: Clinical characteristics, diagnosis and operative strategy
World Journal of Gastroenterology
To evaluate 20 adults with intussusception and to clarify the cause, clinical features, diagnosis, and management of this uncommon entity. A retrospective review of patients aged > 18 years with a diagnosis of intestinal intussusception between 2000 and 2008. Patients with rectal prolapse, prolapse of or around an ostomy and gastroenterostomy intussusception were excluded. There were 20 cases of adult intussusception. Mean age was 47.7 years. Abdominal pain, nausea, and vomiting were the most common symptoms. The majority of intussusceptions were in the small intestine (85%). There were three (15%) cases of colonic intussusception. Enteric intussusception consisted of five jejunojejunal cases, nine ileoileal, and four cases of ileocecal invagination. Among enteric intussusceptions, 14 were secondary to a benign process, and in one of these, the malignant cause was secondary to metastatic lung adenocarcinoma. All colonic lesions were malignant. All cases were treated surgically. A...
Ileocecal intussusception in the adult population: case series of two patients
The western journal of emergency medicine, 2010
Intussusception is a condition found primarily in the pediatric population. In the adult population, however, intussusception is usually due to a pathological process, with a higher risk of bowel obstruction, vascular compromise, inflammatory changes, ischemia, and necrosis. Radiographic and sonographic evidence can aid in the diagnosis. Surgical intervention involving resection of affected bowel is the standard of care in adult cases of intussusception. We present the case of a 21-year-old female who presented to the Emergency Department with diffuse cramping abdominal pain and distention. Workup revealed ileocecal intussusception, with a prior appendectomy scar serving as the lead point discovered during exploratory laparotomy. We also present the case of a 66-year-old male, who presented with one week of intermittent lower abdominal pain associated with several episodes of nausea and vomiting. Workup revealed ileocolic intussusception secondary to adenocarcinoma of the right colo...
Adult intestinal intussusception — A report of 2 cases and literature review
Open Medicine, 2014
Every five years or so a case of adult small bowel intussusception secondary to pathologies such as inflammatory fibroid polyp (IFP) appears in English literature. Likewise rare cases of adult colonic intussusception due to a tumour have been reported including, more recently, their successful management by laparoscopic approach. We describe two such cases, one each of small bowel and large bowel intussusception, due to IFP and caecal tumour respectively and discuss their management. We also suggest role of combined laparoscopy/endoscopy in selected cases of colonic resections.
Hippokratia, 2019
BACKGROUND Bowel intussusception in adults remains a rare and constant diagnostic challenge for surgeons. It has an incidence of around 2-3 new cases per million per year, and its primary cause is benign or malignant neoplasms of the small bowel and colon. This report aims to outline the importance of high clinical suspicion regarding intussusception in adults presenting with abdominal pain in the emergency department. Case report: This is a retrospective review of three cases of adult ileocecal intussusception that were treated in a single surgical department in three years (2015-2018). All patients underwent right hemicolectomy in keeping with the principles of surgical oncology. Each patient had a different clinical presentation, while, in terms of the underlining pathology, the first had an adenocarcinoma of the ascending colon, the second an adenocarcinoma of the ileocecal valve, and the third one an inflammatory fibroid polyp of the ileocecal valve, also known as Vanek's ...
Idiopathic adult colo-colonic intussusception: Case report and review of the literature
International Journal of Surgery Case Reports, 2013
a b s t r a c t INTRODUCTION: Acute colonic intussusception occurring in the absence of organic cause is uncommon in adults. PRESENTATION OF CASE: We report acute colonic intussusception in a 46-year-old female; clinical evidence of a palpable mass, abdominal pain and bloody mucoid stools appeared a few hours after hospital admission. Multislice CT-scan confirmed the clinical diagnosis and surgical exploration revealed right colonic obstruction caused by intussusception of the cecum into the ascending colon. Right hemicolectomy was performed and histopathological examination did not reveal any causative pathology. DISCUSSION: Intussusception remains a rare condition in adults, representing 1-5% of bowel obstruction and accounting for 0.003-0.02% of all hospital admissions. Intussusception occurs more frequently in the small (50-80%) than in the large bowel (12-50%). It is estimated that approximately 90% of intussusceptions in adults are secondary to an anatomical or pathological condition, of which more than half are malignant. Idiopathic cases are the exception in adults. The clinical presentation of adult intussusception differs considerably from the classic pediatric presentation of abdominal pain, palpable mass, and blood per rectum, which is rarely seen in adults. A pre-operative CT-scan showed a 10 cm intussuscepted segment of right colon. Surgical resection was considered mandatory because of severe bowel obstruction, and the theoretical possibility of occult malignancy. This approach was vindicated by the presence of widespread ischemic lesions in the wall of the resected bowel, without any obvious lead point. CONCLUSION: There are few reports in the medical literature of acute colonic intussusception occurring in the absence of organic cause in adults.
Adult Ileocecal Intussusception: A Case Report and Review
The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy, 2019
Intussusception is a rare cause of bowel obstruction in adult patients, it represents for five percent of all age intussusception. Several different aspects were found between adult and pediatric intussusception. We report a case of 39-year-old male with bowel obstruction due to ileocecal intussusception, which firstly diagnosed as acute appendicitis. Unlike pediatric intussusception which usually manifest as classical triad signs, unspecific symptoms of adult intussusception may become diagnostic challenge. Imaging modalities such as plain abdominal radiograph and ultrasonography may aid the preoperative diagnosis in the rural hospital setting. Prompt management which involved surgical approach is warranted to prevent further complications.
2021
Introduction: Intussusception is a clinical condition caused by the “telescopic” prolapse of a proximal part of the bowel into a distal one. In the pediatric age it is a common disease with idiopathic etiology. In adult intussusception is a rare condition and symptoms rarely are acute and are often non-specific, causing a delayed diagnosis. Clinical Report: This report presents the case of a 72-years old woman complaining recurrent abdominal pain with sub-occlusive episodes, who was eventually diagnosed with intussusception caused by an ileal adenocarcinoma, after one year of recurring symptoms. Discussion: Adult intussusception is a rare condition often caused by an underlying benign or malignant disease. The difficult to recognize specific symptoms leads often to a diagnostic delay and in many cases a correct diagnosis is made only during the surgery. Conclusion: Adult intussusception is an infrequent condition that can hide a malignant disease. For this reason surgery should be c...
Adult ileocolic intususception: a case report
International Surgery Journal, 2017
Intussusception is defined as the pathology in which a segment of intestine telescopes into the adjoining intestinal lumen. Ileocolic accounts for 75% of all cases of intussusception. The average age of affected adults is between 50 and 60 years old and it occurs more often in women. The higher percentage of intussusception in adults (65%) occurs due to malignant or benign neoplasms. Appendix is part of intussusception of commonest ileocolic type but appendix as lead point for intussusception is rare. Patient details were collected by patient's IPD file. Complete detailed history, patient vitals, hemogram, ABO, with X-ray Abd erect, USG abdomen and CECT abdomen was done. Post-OP patient was followed by USG review. 60-year-old female diagnosed and operated as for ileocolic intussusception with appendix as lead point. Ileo transverse anastomosis was performed with hemicolectomy involving the terminal ileum along with caecum and ascending colon. Post op patient did well passed stools on 5 th day. Intussusception is a pathology in which a segment of intestine telescopes into the adjoining intestinal lumen causing intestinal obstruction. Intussusception are two types antegrade and retrograde. CT scan and colonoscopy, which provide an accurate diagnosis, allowed the best surgical choice in the hands of an experienced surgeon.
Spontaneous ileo-ileal and ileo-caecal intussusception in adults: Report of two cases
Sakarya Medical Journal, 2014
Having defined as a proximal intestinal segment interpenetrating an adjacent distal intestinal segment lumen in the gastrointestinal system intussusception or invagination, is the most common cause for acute abdomen in children following acute appendicitis.Contrary to childhood period intussusception is rarely encountered among adults. Etiology, clinical presentation and treatment methods are different in adults as well. In etiology of an adult intussusception mostly there are malignant, non-malignant and iatrogenik reasons. İn rare cases the etiology is idiopathic or spontaneous. Spontaneous intussusceptions are mostly seen in small bowel. Diagnose of an adult intussusception can be overlooked or delayed when it is rarely encountered and atypically presented. Treatment is surgical in most cases. In this article, two adult cases of spontaneous ileo-ileal and ileo-caecal intussusception was analysed and presented under current literature considering clinical outlook, diagnose and treatment.
Adult Intussusception Secondary to Colorectal Cancer in a Young Woman: A Case Report
Global Surgery Case Reports, 2020
Adult intussusception (AI) is uncommon condition that represents 1-5 % of intestinal obstruction and is frequently caused by an underlying disease with 70-90% of cases having a demonstrable cause based on imaging findings and surgical results. The most common causes of colonic AI are neoplasm. We report a case of right colo-colic intussusception sustained by a malignant tumor.