Intussusception refers to telescoping of a segment of bowel into adjacent bowel. Only 5% occurs in adults. Causes include neoplasm and inflammatory causes. Caecal endometriosis causing colo colic intussusception is extremely rare condition. A 45-year-old menstruating female presented with complaints of diffuse abdominal pain with vomiting for 10 days. No history of menstrual abnormalities. P/A-mass of 8×5 cm was palpable in right lumbar and umbilical region with mild tenderness. Cect abdomen-colo colic intussusception involving ascending colon and right 2/3rd of transverse colon with no obvious lead point. Patient was taken up for emergency laparotomy and it revealed 1) Intussusception of caecum into ascending colon extending upto hepatic flexure, 2) Multiple black colored nodules over lateral pelvic wall, small bowel, omentum, mesentery, ascending sigmoid colon, 3) Anterior surface of rectum was found to be adherent to posterior surface of uterus and pouch of Douglas inaccessible, 4) Multiple nodes were identified within mesentery. Laparotomy proceeded and gentle manual reduction of intussusceptum was done and growth palpable within caecum, suspecting the growth to be malignant right hemicolectomy with ileocolic end to side anastomosis done. Post operative period uneventful, HPE-endometriosis caecum. Intussusception in adult is rare entity and endometrial mass in caecum acting as lead point has been infrequently reported. Clinical and radiological investigations are of little help in diagnosing endometriosis. Hence, high clinical suspicion is required in patients with previous history of endometriosis.
Cystic neoplasm of pancreas ,a unique entity is gaining its importance due to increased incidence of it's diagnosis .The increased frequency of the diagnosis can be attributed to the heightened usage of the cross sectional imaging such as Computed Tomography ( CT ) and Magnetic Resonance Imaging ( MRI ) .However elucidating the malignant potential of those cysts in a pre operative imaging still remains a challenge and thus a line of demarcation between surveillance and surgery is still undetermined.The differentiation between a serous and mucinous cyst is possible to a certain extent with cross sectional imaging. Mucinous cystic neoplasm carries a high malignant potential compared to the serous neoplasms and hence augmented tissue sampling is required to ascertain malignant potential. Herein presenting a 43 year old female who presented with vague abdominal pain and incidental finding of cystic lesion of the pancreas in Ultrasonography diagnosed with mucinous cystic neoplasm of pancreas in further followup
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