Early discharge after nonoperative management of intussusception is both safe and cost-effective

Arshad, Seyed A.; Hebballi, Nutan B.; Hegde, Brittany N.; Avritscher, Elenir B.C.; John, Susan D.; Lapus, Robert M.; Tsao, Kuo Jen; Kawaguchi, Akemi L.

doi:10.1016/j.jpedsurg.2021.09.047

Cited by 7 publications

(1 citation statement)

References 14 publications

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“…Small intestinal intussusception refers to a section of the small intestine that is overlapped into the adjacent small intestine, and adult small intestinal intussusception is clinically rare with a low incidence of 5%–10%, accounting for 1%–5% of adult intestinal obstruction ( 3 ). It is different from children's intussusception that 70%–90% of small intestinal intussusception in adults is due to the pathological causes, mainly secondary to small bowel occupying, which include lipomas, gastrointestinal mesenchymal tumors, polyps, small bowel metastases, and malignant melanoma, and nonoccupying lesions, such as Meckel's diverticulum and inflammatory lesions of the small bowel ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Intussusception Related to Small Intestinal Lipomas: A Case Report and Review of the Literature

Wu²,

Sun³

2022

Front. Surg.

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IntroductionAdult intussusception is a rare disease that is difficult to diagnose and treat and is even rarer when it is caused by a lipoma of the small intestine. We reported a case of a small intestine lipoma combined with intussusception, which can guide people in future clinical work.Case PresentationA 51-year-old female was admitted to the hospital with “abdominal pain for 1 month.” Enhanced computed tomography (CT) of the abdomen suggested a lipoma in the left lower quadrant and a proximal intussusception. After excluding surgical contraindications, laparoscopic exploration was performed on the second day of admission, which showed a small amount of ascites in the abdominal cavity, a small intestine–small intestine-type intussusception about 20 cm from the ileocecal area and about 140 cm from the ileocecal area, and a mass of about 2×4 cm that was palpable by laparoscopic intestinal forceps, which was protruded into the intestinal cavity with a soft texture and sound mobility. A 5 cm-long incision was made above the mass to dissect into the abdomen layer by layer, and the diseased intestine was dislodged outside the abdominal cavity with oval forceps. The intestine was reduced by hand and observed for half an hour after reduction, and the blood circulation and peristalsis of the intestine were observed to be still sound. The intestine was dissected at 2 cm from the upper and lower margins of the mass using linear anastomosis to operate small intestine side-to-side anastomosis. The intestine was opened concurrently and closed with a linear anastomosis, using 3-0 absorbable thread to reinforce anastomosis intermittently. The procedure went smoothly, and the patient was discharged on the 5th postoperative day.ConclusionA small intestinal lipoma combined with small intestinal intussusception is rare in clinical practice and needs to be diagnosed by asking history detailedly, physical examination, and relevant ancillary tests such as abdominal CT. Laparoscopic-assisted small incision surgery for adult intussusception combines the advantages of laparoscopic surgery and laparotomy, operating simply and easily.

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Section: Discussionmentioning

confidence: 99%

Intussusception Related to Small Intestinal Lipomas: A Case Report and Review of the Literature

Wu²,

Sun³

2022

Front. Surg.

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Intussusception in Children: Diagnostic Imaging and Treatment

Otero,

De Leon Benedetti,

Applegate

2023

Evidence-Based Imaging

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One-stage transanal endorectal pull-through for Hirschsprung disease: experience with 229 neonates

Zhang

Liu

et al. 2022

Pediatr Surg Int

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To evaluate the safety and e cacy of the transanal endorectal pull-through (TEPT) and the long-term outcomes in newborns with HD. MethodsA total of 229 newborns with HD underwent one-stage TEPT between 2007 and 2020, and the diagnoses were con rmed by rectal biopsy. The perioperative clinical course for all patients was reviewed, and the postoperative short-and long-term outcomes were assessed. ResultsA total of 229 neonates (187 male and 42 female) had a median age at TEPT of 17 days (range, 6-28 days). Sixty-eight patients (29.7%) underwent TEPT combined with an abdominal approach or laparoscopy. Early postoperative complications were documented in 26 patients (11.4%). The follow-up period in the remaining 165 children ranged from 1.2 to 14.0 years (median, 5.0 years), and late postoperative complications were noted in 6 patients (3.6%). A total of 106 of the patients older than four years old took part in an interview about bowel function, and 85 patients (80.2%) had a bowel function scores (BFS) ≥ 18. ConclusionTEPT is effective and safe in the treatment of neonatal HD and presents with a low rate of complications and an acceptable outcome.

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Early discharge after nonoperative management of intussusception is both safe and cost-effective

Cited by 7 publications

References 14 publications

Intussusception Related to Small Intestinal Lipomas: A Case Report and Review of the Literature

Intussusception Related to Small Intestinal Lipomas: A Case Report and Review of the Literature

Intussusception in Children: Diagnostic Imaging and Treatment

One-stage transanal endorectal pull-through for Hirschsprung disease: experience with 229 neonates

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