Intussusception of the small bowel secondary to malignant metastases in two 80-year-old people: a case series (original) (raw)

Predictive Factors of Malignancy in Adults with Intussusception

World Journal of Surgery, 2006

Introduction: Adult intussusception is an unusual entity, and its etiology differs from that in pediatric patients. The aim of this study was to evaluate our experience of 60 adult patients with intussusception and determine if there are any preoperative factors predictive of malignancy. Methods: The records of 60 adult patients (> 18 years of age) with a diagnosis of intussusception surgically treated at Singapore General Hospital and Changi General Hospital between 1990 and 2004 were retrospectively reviewed. The intussusceptions were classified as enteric or colonic. Preoperative predictive factors of malignancy were analyzed using univariate and multivariate analyses, and P < 0.05 was considered statistically significant. Results: There were 60 patients with a median age of 57.5 years (range 21-85 years). Altogether, 34 (56.7%) patients were male, and there were 31 enteric and 29 colonic intussusceptions. A lead point was identified in 54 patients (90%). A total of 22 (36.7%) patients presented with intestinal obstruction, and the correct preoperative diagnosis of intussusception was made in 31 patients (51.7%). Computed tomography was the most useful diagnostic modality, correctly identifying an intussusception in 24 of 30 patients. A malignant pathology was present in 8 of 31 (26%) enteric versus 20 of 29 (69%) colonic intussusceptions. Age (P = 0.009), the presence of anemia (P < 0.001), and the site of the intussusception (P = 0.001) showed significant differences between the benign and malignant groups by univariate analyses. On multivariate analysis, intussusception in the colon (P = 0.004) and the presence of anemia (P = 0.001) were independent predictive factors of malignancy. Conclusions: Adult intussusception is most commonly secondary to a pathologic lead point. The site of intussusception in the colon and the presence of anemia are independent preoperative predictors of malignancy. All colonic intussusceptions should be resected en bloc without reduction, whereas a more selective approach can be applied for enteric intussusceptions.

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.

A semi-emergency surgery case of jejunal intussusception in an adult due to tumor

Annals of Cancer Research and Therapy, 2020

The present case report describes a 21-year-old male patient with intussusception of the small intestine due to adenoma. The patient presented with acute onset of severe abdominal pain, with clinical symptoms and preoperative ultrasonography raising a differential diagnosis of intussusception. Laparotomy identified a mass lesion within the small intestine as the leading point of intussusception, highlighting the importance of preoperatively evaluating neoplastic lesions in adult intussusception.

Adult intussusception by tumor in ileum: a diagnostic dilemma

Intussusception in adults is an infrequent cause of intestinal obstruction; preoperative diagnosis is difficult as symptoms can be intermittent and long standing. This relatively rare entity differs from the childhood form in its etiology, presentation and treatment. We present two cases of ileo-colic intussusception in adults, with a clinical presentation that mimicked complicated appendicitis. These cases remind us that both ileal tumors and intussusception must be included in the diagnosis of lower abdominal pain.

Adult intussusception: An institutional experience and review of literature

Archives of International Surgery, 2014

Background: In adults, intussusceptions represent an uncommon form of intestinal obstruction, diagnosed in only 1-5% of cases. It can be idiopathic or secondary to a pathology in the bowel, which may be a malignancy in 9.75% of small bowel intussusceptions and 50-60% of large bowel intussusceptions. The aim of this study was to make a 15 year institutional review of adult intussusceptions. Materials and Methods: Over a period of 15 years from January 1998 to December 2012, a total of 17 patients were diagnosed and managed as intussusceptions in our institution. A retrospective analysis of clinical, imaging and management data along with specimen and histopathological analysis was carried out. Results: The age range was 21-58 years (mean 35 years) with a male preponderance (11 males: 6 females). Intussusceptions affected the small bowel in 12/17 (70.59%) and the large bowel in 5/17 (29.41%) of cases. The most common clinical presentation was insidious abdominal pain with sub-acute obstruction in 15/17 (88.24) of cases. Computed tomography scan was diagnostic in 88.23% cases. Intestinal tuberculosis (TB) was the most common etiology in 23.53% of the patients. Small bowel intussusceptions were not associated with malignancy, but all cases due to post-operative causes or TB affected small bowel only. Malignancy was responsible for intussusceptions only in the large bowel. Conclusions: On analysis of our cases, we found that malignancy is responsible for intussusception only in the large bowel. Small bowel intussusceptions were not associated with malignancy, but all cases due to post-operative cause or TB affected small bowel only.

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...

Ileoileal intussusception due to metastatic melanoma

Case Reports International, 2019

Introduction: Intussusception in adults is rare, and can be classified into intussusception with a pathological lead point, or intussusception without a lead point. Case Report: This case report describes a 63-year-old male with a history of metastatic melanoma who presented with a two-month history of abdominal pain, which was due to an ileoileal intussusception with metastatic melanoma deposit at the lead point. He was managed with laparoscopic small bowel resection, leading to resolution of his symptoms. Conclusion: A low threshold for surgical exploration is recommended in adults with intussusception for definitive diagnosis of the cause and for symptom management.