Inflammatory Fibroid Polyp of the Jejunum Causing Intussusception

Inflammatory fibroid polyp of jejunum is a very rare nonneoplastic lesion of gastrointestinal tract. We reported a 66-year-old male who presented with abdominal fullness, colicky pain, and vomiting for 4 days. Plain abdomen showed intestinal obstruction with dilated small bowel loops. The exploratory laparotomy was performed under the clinical impression of intussusception caused by small bowel tumor. The diagnosis of an inflammatory fibroid polyp causing jejunojejunal intussusception was confirmed after surgery.     

Burkitt lymphoma as a lead point for jejunojejunal intussusception in a human immunodeficiency virus patient

Intussusception is commonly seen in children but is rare in adults and represents only 5% of all intussusceptions causing 1% of intestinal obstructions. More than 50% of these intussusceptions in adults are due to intestinal neoplasms, including malignant lymphoma, e.g., Burkitt lymphoma. These lymphomas are more common in human immunodeficiency virus (HIV)-positive patients than in the general population. We present a case of a young male who was diagnosed with HIV when he developed intestinal obstruction and intussusception secondary to Burkitt lymphoma. He was managed with surgical resection followed by chemotherapy and antiretroviral treatment. HIV patients presenting with acute abdomen pose a diagnostic challenge to clinicians due to a wide range of differential diagnoses including inflammatory, infectious and neoplastic conditions. In a young HIV patient presenting with acute abdomen, intussusception caused by Burkitt lymphoma should be considered in the differential.     

Jejunal Lipoma With Intermittent Intussusception Revealed by Partial Obstructive Syndrome

Jejunojejunal intussusceptions are not very common in adults, and unlike in children, a lead point is usually found. The clinical presentations in adults tend to be more chronic or intermittent, and they include obstructive syndrome, abdominal cramps, gastrointestinal bleeding, or palpable abdominal mass at physical examination. These unspecific symptoms often lead to late diagnosis after many investigations or even only after an inappropriately extensive surgery. We report the rare case of a 37-year-old female with intermittent bowel obstruction due to jejunojejunal intussusception secondary to the lipoma. The main clinical signs of this uncommon pathology are presented together with the necessary paraclinical investigations that enable surgical treatment.     

Jejunal tubulovillous adenocarcinoma in adenoma presenting with entero-enteric intussusception

A 73-year-old male was admitted to our institution with complaints of nausea, vomiting, and abdominal distension. Plain abdominal computed tomography (CT) suggested intussusception in the jejunum. Enhanced abdominal CT revealed the ‘target-like’ sign and ultrasonography revealed the ‘multiple concentric ring’ sign; therefore, a diagnosis of entero-enteric intussusception was made. The small intestinal obstruction and cause of the intussusception were not evident. The patient was treated conservatively with fasting and transfusion therapy to prevent intestinal obstruction. However, with no spontaneous resolution of intussusception, surgical treatment was decided. The operative findings revealed a jejunal tumor about 30 cm from the Treiz ligament, and the jejunum including the tumor with a 5 cm margin were partially resected. The resected tumor was a 35 × 50 mm soft mass spreading laterally with nodules. The pathological examinations revealed tubulovillous adenocarcinoma in the adenoma. Intussusception is rare in adults compared to children. About 45 % of cases of intussusception in adults are due to small intestinal tumors such as malignant lymphoma or lipoma, but a tubulovillous adenocarcinoma with adenoma is a rare cause of intussusception. We present a rare case of jejunal tubulovillous adenocarcinoma in adenoma presenting with entero-enteric intussusception.     

Ileo-ileal intussusception caused by diffuse large B-cell lymphoma of the ileum

The occurrence of adult intussusception from small intestinal lymphoma is quite rare.We present an82-year-old man with a two-month history of intermittent abdominal pain,nausea and fatigue.Clinical symptoms included moderate abdominal tenderness in the right lower abdomen.Computed tomography scan of the abdomen revealed a mass in the terminal ileum with the sign of"bowel within bowel"which was suspicious of ileo-ileum intussusception.The patient underwent laparoscopic segmental ileal resection.Pathologic evaluation revealed a diffuse large B cell non-Hodgkin’s lymphoma of the ileum.The postoperative course was uneventful.     

Laparoscopic Surgery for Adult Intussusception: Case Series

BackgroundIntussusception is a rare condition in adults which accounts for 1% of all intestinal obstructions. It usually requires surgical treatment and the classic approach is laparotomy. This article presented six adult patients who underwent laparoscopic surgery for intestinal obstruction due to intussusception.MethodBetween January 2017 and July 2019, six adult patients underwent laparoscopic surgery for intestinal obstruction due to intussusception. The patients were evaluated in terms of presenting symptoms, diagnosis, treatment modality, morbidity, mortality and histopathological results.ResultsAll patients presented with acute (50%) or subacute (50%) symptoms. All patients had intestinal obstruction (partial, complete) findings. Intussusception was diagnosed by abdominal computed tomography (CT). The patients with ileocolic and colo-colonic intussusception underwent colonoscopy. In the preoperative period, the etiology of intussusception (neoplasm, idiopathic, etc.) was diagnosed only in one patient (16.6%). Two patients underwent laparoscopic segmental small bowel resection, two patients underwent laparoscopic right hemicolectomy, one patient underwent laparoscopic left hemicolectomy, and one patient underwent laparoscopic anterior resection. None of the patients developed intraoperative or postoperative complication. The histopathological examination revealed malignancy in two patients (33.3%).ConclusionCT is helpful in diagnosing of adult intussusception. However, it is usually difficult to define the underlying pathology with CT. Laparoscopic approach seems to be safe and effective as open surgery, both in diagnosis and treatment of intussusception.     

Inflammatory myofibroblastic tumor causing ileoileal intussusception: an unusual cause of an unusual neoplasm in an adult, with a clinicopathological review of the literature

An inflammatory myofibroblastic tumor (IMT) of the ileum is a very rare lesion of the gastrointestinal tract. A 36-year-old female presented with abdominal fullness and colicky pain of 5 days' duration. Plain abdominal radiography showed an intestinal obstruction with dilated jejunal loops. Abdominal computed tomography and ultrasonography demonstrated a well-defined intraluminal solid mass surrounded by the typical mural layers of an invaginated ileum. The patient then underwent an exploratory laparotomy under a clinical diagnosis of intussusception caused by a small bowel tumor. The surgical findings revealed a large mass leading to an ileoileal intussusception, with regional lymph node enlargement and a small bowel resection accompanied by lymph node dissection was performed. The definitive diagnosis of IMT was confirmed by both conventional histopathology and minute immunohistochemistry.     

Intususcepción ileocólica en un adulto causado por divertículo de Meckel invertido

Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is found in 2.00% of the population and is more frequent in children. Invagination is an unusual complication that can cause secondary intestinal intussusception. This event is extremely rare and only a few cases have been reported. We present the case of a 19-year-old male who presented with chronic abdominal pain and weight loss of 23 Kg 6 months prior to hospital admittance. The last episode manifested as intense abdominal pain, nausea, vomiting, and diarrhea with a 6-hour progression. Imaging studies established the diagnosis of bowel obstruction and ileocolic intussusception. Laparotomy with ileocolic resection was performed without reducing the intussusception. The histopathologic study reported inverted Meckel's diverticulum at the base of the ileocolic intussusception. Intestinal intussusception in adults, secondary to inverted Meckel's diverticulum is rare and should be considered in the differential diagnosis of patients presenting with abdominal pain and bowel obstruction.     

Acute adult intussusception caused by primary cecal non Hodgkin lymphoma

Intussusception of the bowel is rather rare in adults and in about 80-90% of the cases is secondary to an underlying intraluminal pathology that serves as a lead point. In cases of colonic intussusception malignancy occurs in 63-66% of patients and it is usually adenocarcinoma and rarely lymphoma. The presenting symptoms are non specific and are in most cases of long duration, consistent with a chronic intussusception causing partial intestinal obstruction. We present a rare case of primary colorectal lymphoma in a 29 years old female that was complicated by acute ileocecal intussusception, treated with en bloc resection without reduction.     

Inflammatory Fibroid Polyp of the Ileum Which Could be Endoscopically Diagnosed —A Case Report and Review of the Literature—

Abstract: Inflammatory fibroid polyp (IFP) of the small intestine is a very rare disease. Our review of the literature revealed only 40 cases of small intestinal IFP were reported from July 1975 through August 1989 in Japan. It is extremely difficult to make a definite diagnosis of IFP prior to surgery; none of the cases reported were diagnosed preoperatively. We describe here the first case of small intestinal IFP in Japan whose diagnosis was strongly suspected from an endoscopic examination prior to surgery. A 62-year-old woman was admitted to our hospital with diarrhea, abdominal pain, nausea and vomiting. A plain abdominal x-ray revealed the presence of an ileus. The subsequent contrast x-ray performed via a long intestinal decompression tube and colonoscopic observation found an ileo-ileal intussusception caused by a spherical mass (about 30 mm in diameter) in the ileum. When pushed with forceps, the tumor demonstrated a rubber-like hardness, suggesting the presence of an IFP. Surgery was performed to treat the intestinal obstruction, and the ileo-ileal intussusception was confirmed at a site 30 cm proximal to the ileocecal valve. At the leading point of the intussusception there was a semipedunculated tumor of 30X30X25 mm in size. The intestinal tumor was histopathologically diagnosed as IFP.     

Ileocolic intussusception secondary to Hodgkin´s lymphoma. Report of a case

Intussusception is a rare J75condition in adults and represents 1% to 5% of the total cases of intestinal obstruction. Preoperative diagnosis occurs only in a few patients and most of the cases are diagnosed during surgery. A demonstrable etiology is found in 70% to 90% of cases in adult intussusceptions, and approximately 40% of them are caused by primary or secondary malignant tumors. We report the case of a 32 year old male patient with an ileocolic intussusception secondary to Hodgkin's lymphoma, as well as the surgical treatment, and outcome.     

Colo-colonic intussusception in an adult: an unusual presentation of perforated diverticulitis

We describe an unusual case of acute bowel obstruction caused by a colo-colonic intussusception associated with perforated sigmoid diverticulitis in an adult. Radiographic and pathologic features of the colo-colonic intussusception are presented. A review of the recent literature with regard to the clinical symptoms, signs, diagnosis, etiology, and treatment of colo-colonic intussusception is provided. Colo-colonic intussusception is a rare cause of acute intestinal obstruction in the adult and is usually associated with a malignancy. Treatment should include primary resection without attempts at reduction of the intussusception. Received: 26 February 2000 / Accepted in revised form: 10 June 2000     

Eosinophilic enteritis presenting as a rare cause for ileo-ileal intussusception

Eosinophilic enteritis,a relatively rare entity,usually involves gastric antrum or proximal small bowel. Our case is rarer in its involvement of the distal small bowel and presents unusually as intussusception. The disease if diagnosed in the initial stages responds well to medical treatment but if associated with complications or misdiagnosed,surgical modality is the treatment of choice. In our case,the patient presented with acute intestinal obstruction due to intussusception and emergency laparotomy with ileoileal anastomosis was done. Histopathology confirmed the diagnosis as eosinophilic enteritis. This case with such a presentation is discussed here.     

Acute Jejunogastric Intussusception—A Case Report

Abstract: Acute jejunogastric intussusception is often a life-threating complication of gastric surgery. The present case of acute retrograde jejunogastric intussusception occurred twenty years after a Billroth II partial gastrectomy. Acute pancreatitis was misdiagnosed primarily became of a low suspicion index. The diagnosis was establised by gastroscopy and radiography. During surgery, an intussusception of 30 cm of the efferent jejunum was reduced. Jejunogastric intussusception should be strongly suspected in all patients who Present with epigastric pain, vomiting, hematemesis, abdominal mass, or/and high intestinal obstruction after previous gastric surgery.     

Chronic intestinal pseudoobstruction: report of four pediatric patients.

Chronic intestinal pseudoobstruction is a rare disorder of intestinal motility, characterized by recurrence of continuous symptoms and signs of intestinal obstruction in the absence of true mechanical obstruction. Congenital or systemic disorders are the causes of chronic intestinal pseudoobstruction. The term idiopathic is applied when there is no congenital or secondary cause. Early diagnosis of intestinal pseudoobstruction is important to avoid repeated laparotomies. Treatment of chronic intestinal pseudoobstruction is usually supportive. Besides the supportive therapy, prokinetic agents such as erythromycin and octreotide are used in the therapy. In this article, four pediatric patients diagnosed as chronic intestinal pseudoobstruction are discussed with their clinical findings and laboratory abnormalities. The etiology of chronic intestinal pseudoobstruction was visceral myopathy in one patient. Two had idiopathic chronic intestinal pseudoobstruction and the other patient developed chronic intestinal pseudoobstruction after cardiac surgery. Erythromycin was administered to all four patients, one of whom did not respond to this therapy. Octreotide was effective in this case.     

成人肠套叠43例诊疗分析

目的探讨成人肠套叠的病因、诊断及治疗方法。 方法对湖南中医药大学第一附属医院43例成人肠套叠的临床表现、类型、诊断及治疗方法行回顾性分析。 结果阵发性腹痛为主要症状,其次为恶心呕吐、腹胀、肛门停止排便排气、腹部包块、便血/果酱样便等。辅助检查腹部CT确诊39例,成人肠套叠2例保守治疗成功复位,1例放弃治疗出院,40例行手术治疗。小肠套叠28例,其中良性病变18例,依次为小肠腺瘤、脂肪瘤、粘连、异物等;恶性病变10例,分别为间质瘤、非霍奇金淋巴瘤、腺癌和肉瘤。回盲部及结肠套叠83%为恶性肿瘤,均为腺癌。42例患者均康复出院。 结论成人肠套叠多由器质性病变引起,诊断主要依据临床表现和辅助检查,治疗以手术为主。     

Un cas d’invagination intestinale subaigu? sur diverticule de Meckel chez une adolescente au CHU Campus de Lomé en 2008

Adult intussusception is rare; the Meckel’s diverticulum is also a rare entity. Chronic abdominal pain, low digestive haemorrhages and the recurring obstructive symptoms can lead to an useless delay in the diagnosis. This case report describes a rare cause of adult intestinal intussusception due to Meckel’s diverticulum in order to point out the clinical, radiological aspects then therapeutic of this affection.     

Deflated intragastric balloon-induced small bowel obstruction

We describe the rare case of a 49-year-old man who had an air-filled intragastric balloon placed for weight control 11 months ago which had been lost of sight for follow-up and presented six months after the last radiologic control with acute small bowel obstruction. Computed tomography confirmed the migration of the deflated balloon in the small bowel. It was impacted in the ileum so an enterostomy-suture was performed for removal. Intragastric balloons are temporarily used to obtain weight reduction in the super-obese prior to bariatric surgery and in patients who are not fit for surgery. They were shown to be effective in restoring the metabolic syndrome as well. The use of fluid-filled balloons seems preferable for early migration diagnosis and management. If the intragastric balloon remains inside longer than recommended, it tends to deflate and is prone for migration and intestinal obstruction. Follow-up investigations (monthly X-rays) are mandatory for early migration diagnosis.     

Chronic Intestinal Pseudo-obstruction with Mitochondrial Diseases

Chronic intestinal pseudo-obstruction (CIPO) is a rare disorder of intestinal dysmotility characterized by chronic symptoms, including vomiting and abdominal pain, associated with bowel obstruction without any mechanical obstructive causes. We herein report a case of mitochondrial diseases with recurrent duodenal obstruction that was initially diagnosed as superior mesenteric artery syndrome (SMAS) for a few years but was later diagnosed as CIPO. Since CIPO is known to be associated with mitochondrial diseases, it should be considered in the differential diagnosis of patients with mitochondrial diseases presenting with recurrent intestinal obstruction.     

Invagination intestinale aiguë de l’adulte. À propos de trois cas

The ailment intestinal intussusception is rare and could be chronic. We report three cases of intestinal intussusception in adult and discuss preoperative diagnosis and surgical procedures.