Intussusception due to rectal adenocarcinoma in a young adult: A case report

An intussusception due to colonic adenocarcinoma has sometimes been reported. However, to the best of our knowledge, reports of intussusception due to rectal adenocarcinoma are extremely rare. In this report, the case of a young man with rectal adenocarcinoma causing intussusception is described. A 24-year-old man visited a hospital complaining of abdominal pain, and an upper rectal cancer was diagnosed by colonoscopy. Computed tomography showed intussusception caused by a large tumor in the pelvis and absence of distant metastases. Locally advanced rectal cancer causing intussusception was diagnosed, and a low anterior resection was performed. Intraoperatively, repair of the invagination could not be accomplished easily; therefore, the repair was abandoned. Instead, the tumor was removed en bloc to avoid dissemination of the cancer. Histopathologically, the tumor was diagnosed as a poorly differentiated adenocarcinoma, pStage IIA. The patient has no evidence of recurrence at 10 mo after the operation.     

Volvulus of the splenic flexure of colon: a case report and review

We report a case of splenic flexure volvulus in a patient who had previously been operated upon for a sigmoid volvulus. The clinical features and management of plenic flexure volvulus are discussed. Accepted: 14 April 2000     

Intussusception in an adult patient with severe hyperglycaemia--a case report.

AIMS: To report a case of adult intussusception associated with and possibly induced by acute hyperglycaemia. METHODS: We present the first case report of adult intussusception with severe hyperglycaemia. Clinical and laboratory data together with radiological findings are presented with a brief review of the literature. RESULTS: A 20-year-old man with no past medical history presented with abdominal pain for 2 days. The patient was severely hyperglycaemic with blood glucose of 72.7 mmol/l (normal 3.3-6.1 mmol/l), a pH of 7.2 and serum potassium of 6.5 mmol/l (normal 3.5-5.0 mmol/l). He had a computed tomography (CT) scan of the abdomen that revealed small bowel intussusception. Upon treatment of his hyperglycaemia, the patient's abdominal pain completely resolved. Follow up abdominal CT revealed complete resolution of the previously detected intussusception. CONCLUSION: Clinicians should be aware of the potential for the occurrence of intussusception in severely hyperglycaemic patients. Correction of hyperglycaemia could lead to resolution of the intussusception without surgical intervention. Possible effects of hyperkalaemia and/or acidosis on gastrointestinal motility should also be considered.     

Rare case of left colic flexure is supplied by a branch from splenic artery--a case report

A variation of a branch of the splenic artery was reported in a Taiwanese male cadaver during dissection in 1999. This artery arose from the splenic artery and ran inferiolaterally to the area of the left colic flexure. Since left colic flexure is a segment of embryonic hindgut and the splenic artery typically supplies the foregut, the condition in which an artery of foregut crosses midgut to supply an area of the hindgut becomes interesting.     

Volvulus of the splenic flexure: Report of a case

Summary A case of volvulus of the splenic flexure occurring in a patient with regional ileitis and lactase deficiency is presented. The pertinent features of 12 previously reported cases are reviewed. Awareness of this rare cause of colonic obstruction and its radiographic presentation are important in the proper management of these patients.     

Gastrocolic fistula secondary to diverticulitis of the splenic flexure: Report of a case

Summary A gastrocolic fistula was demonstrated on barium-enema examination of a patient with recurrent left upper abdominal pain. The underlying cause proved to be perforated diverticulitis of the splenic flexure. This unusual etiology may be considered when the radiologic evidence for gastrocolic fistula and colonic diverticula occur together.     

Isolated splenic vein thrombosis secondary to splenic metastasis： A case report

INTRODUCTIONIsolated splenic vein thrombosis is a rare clinical syndrome that may lead to left-sided portal hypertension.Metastasis to the spleen from solid tumors is also considered rare.When identified it usually occurs in the setting of widely dissemin…     

Recurrent abdominal complaints caused by a cecal neurofibroma: a case report

Gastrointestinal involvement of neurof ibromatosis type 1 (NF1, Von Recklinghausen’s disease) is generally associated with the upper gastrointestinal tract. Abdominal manifestation of NF1 includes several tumors such as malignant peripheral nerve sheath tumors, gastrointestinal stromal tumors and ampulla of vater tumors. However, colonic involvement in NF1 patients is rare. We report a case of a patient presenting with dysphagia, weight loss, intermittent abdominal pain and constipation caused by a single c...     

Omental teratoma in an adult: a case report

We recently experienced an omental teratoma in a 34-year-old woman. Ultrasonography (US) revealed a large mass of mixed echogenicity, occupying the entire lower abdomen. Computed tomography showed an inhomogeneous solid and cystic mass in the abdominal cavity containing fat and calcification.     

Splenic flexure colonic volvulus: a pediatric case report

Volvulus of the colon is an unusual cause of intestinal obstruction in the pediatric population. Splenic flexure colonic volvulus is the most uncommon site in children. We report a case of splenic flexure volvulus (SFV) in a 21-month-old boy with underlying cerebral palsy and epilepsy. He experienced abdominal distension, bilious vomiting and absence of bowel movement for 2 days. Abdominal radiography showed a proximal distended colon and a "coffee bean sign" at the left upper quadrant. Barium enema revealed a "bird beak sign" at the splenic flexure, which confirmed the diagnosis of SFV. Detorsion of SFV occurred while undergoing exploratory laparotomy. He received regular follow-up in the subsequent 3 years without recurrence.     

Survival after resection of carcinoma of the splenic flexure

Nine hundred ten patients undergoing colectomy for colon cancer were studied retrospectively. Seventy-four cancers (8 percent) were located at the splenic flexure. The stage at presentation was no different between splenic flexure cancers and colon carcinomas at other sites. Although splenic flexure cancers had twice the incidence of obstruction as did other colon cancers and obstruction in the overall series adversely affected survival, there was no difference in survival between splenic flexure cancer patients and patients with other colon cancers.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, April 29–May 4, 1990.     

Congenital bronchoesophageal fistula in an adult： A case report

Bronchoesophageal fistulas are usually diagnosed in the neonatal period. As such, the condition is rare in adults. We present a case of a congenital bronchoesophageal fistula in a 62-year-old man with the complaint of severe bouts of cough and choking after swallowing liquid. His workup included a barium esophagogram that revealed a fistula between the esophagus and a right lower lobe bronchus. The diagnosis should be considered in certain individuals with suggestive symptomatology and unexplained respiratory pathology. The fistula was divided and resected, The patient had an uneventful recovery.     

Meningococcocemia complicated by disseminated intravascular coagulation, splenic infarction and pulmonary thromboembolism in a young adult: case report

Mortality of meningococcal septicemia remains high in spite of the improvement of antibiotics treatment and critical care medicine. A 23-year-old male, who had been well until a day earlier, was admitted to the hospital because of a high-grade fever and headache. On the second hospital day, he was still febrile, and it was confirmed that he had disseminated intravascular coagulation. There was no purpuric skin lesion, and a lumbar puncture revealed no abnormality. The condition was complicated by a splenic infarction on the second hospital day, and he suffered a pulmonary infarction on the 8th hospital day. The blood culture was positive for Neisseria meningitidis, making the diagnosis meningococcal septicemia. He was successfully treated with antibiotics and intensive care. Although meningococcocemia in adults is relatively rare in Japan, the disease mortality is still high even in the modern era. Then, once the diagnosis is suspected, it is essential to keep in mind that meningococcal infection requires early recognition of the disease process, prompt initiation of adequate antiinfectious therapy and intensive treatment of multiorgan failure.     

Volvulus of the splenic flexure: Report of a case and review of the literature

This is the first case report of gangrenous colon from volvulus of the splenic flexure. It is also the first reported treatment of splenic flexure volvulus by exteriorization of the splenic flexure as a loop colostomy. Splenic flexure volvulus has been a rare cause of mechanical obstruction, producing 1 per cent of colonic volvuluses. Fourteen detailed case reports of splenic flexure volvulus were reviewed. Patients averaged 53.2 years old. Eight of 14 were women. Previous abdominal surgery, anomalies of fixation, and constipation played important roles in the pathogenesis. Diagnosis was made before surgery in two-thirds of the patients. Treatment varied. One patient died without treatment. In two, the volvulus reduced spontaneously. Eleven required emergency surgery. Three underwent operative detorsion, one exteriorization of the splenic flexure as a loop colostomy (the present report), and six partial colectomy. All treated patients survived without recurrence of volvulus. Thus, there was only one death in 14 cases, a seven per cent mortality rate. This low mortality rate was attributed to the rarity of gangrenous colon from splenic flexure volvulus.     

A case report: an ileus caused by cecal volvulus and intersigmoidal hernia due to mesenterium commune]

A 33-year old woman was referred to our hospital because of gradually progressing abdominal pain and abdominal distension. A computed tomography demonstrated that distended cecum was located in the left retroperitoneal space. Barium enema revealed that the descending colon was positioned at the right side of the abdomen and transverse colon became severely tapered. Ceacal volvulus in addition to the internal herniation into the left retroperitoneal space was clinically diagnosed. The patient received an emergent operation. Operative findings showed that mesenterium commune, no fixation of the colon to the retroperitonium, and the internal herniation of terminal ileum to transverse colon into the sigmoid mesentery. Moreover, the cecal volvulus was diagnosed at the left retroperitoneal space. The mesenterium commune with internal herniation and cecal volvulus is extremely rare but one of important causes of acute abdomen.     

Isolated splenic vein thrombosis secondary to splenic metastasis: A case report

A 49-year-old, previously healthy woman sought treatment for abdominal pain. Colonoscopy revealed ascending colon cancer. Computed tomography and angiography showed splenic metastasis and thrombosis extending from the splenic vein to the portal vein. She underwent right hemicolectomy, splenectomy, and distal pancreatomy. Histological findings showed no malignant cell in the splenic vein which was filled with organizing thrombus. We postulate the mechanism of splenic vein thrombosis in our case to be secondary to the extrinsic compression of the splenic vein by the splenic metastasis or by the inflammatory process produced by the splenic metastasis. In conclusion, we suggest that splenic metastasis should be added to the list of differential diagnosis which causes splenic vein thrombosis. In the absence of other sites of neoplastic disease, splenectomy seems to be the preferred therapy because it can be performed with low morbidity and harbors the potential for long-term survival.