No abstract

LIS is superior to non-surgical therapies in achieving sustained cure of fissure. Calcium channel blockers were more effective than GTN and with less risk of headache, but with only a low quality of evidence. Anal incontinence, once thought to be a frequent risk with LIS, was found in various subgroups in this review to have a risk between 3.4 and 4.4%. Among the surgical studies, manual anal stretch performed worse than LIS in the treatment of chronic anal fissure in adults. For those patients requiring surgery for anal fissure, open LIS and closed LIS appear to be equally efficacious, with a moderate GRADE quality of evidence. All other GRADE evaluations of procedures were low to very low due mostly to imprecision.

These animal studies and clinical cases suggest that transesophageal intracardiac procedures could become feasible and that further exploration by gastroenterologists and cardiologists may be justified.

The utility of CT imaging in the diagnosis and management of patients presenting with acute abdominal pain is confirmed, but is limited in a minority of cases where poor negative interobserver agreement exists. Good communication to the reporting radiologist of the relevant patient history and clinical question becomes important.

HighlightsThis case reiterates treatment modalities for adult intussusception.Intestinal lipomatosis complicated by intussusception in an adult.Cross sectional imaging can aid in the diagnosis and the treatment is surgical resection of the affected segments.