Intestinal intussusception in a young women: unusual cause and specific management

Elm’hadi, Choukri; Tarchouli, Mohamed; Khmamouche, Mohamed Réda; Tanz, Rachid; Elfahssi, Mohammed; Kettani, Fouad; Ali, Abdelmounaim Ait; Errihani, Hassan; Ichou, Mohammed

doi:10.1186/s12957-015-0660-0

Cited by 14 publications

(11 citation statements)

References 15 publications

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“…12 In adults, the clinical presentation of intussusception can be nonspecific, rarely presenting with the classic triad of abdominal pain, palpable mass, and bloody stool. [13][14][15] Instead, it presents with symptoms of small or large bowel obstruction. The most common presenting symptom is abdominal pain, 14,16 with associated symptoms consistent with partial obstruction: nausea, vomiting, obstipation, gastrointestinal bleeding, change in bowel habits, constipation, or bloating.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…1-4). 13,14,19 Additionally, mesenteric vessels within the bowel lumen are characteristic on CT, showing compromised vascular perfusion in terms of venous stasis, edema, and air in the bowel wall due to necrosis or gangrene. 14 Despite the benefits of CT, Martín-Lorenzo et al found that while CT is extraordinarily sensitive for detecting intussusception, it is limited by less accessibility, a static and single plane exploration, radiation, and finally oral and IV contrast which could further delay the study and thus the proper diagnosis.…”

Section: Patient Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Intestinal Intussusception: Etiology, Diagnosis, and Treatment

Marsicovetere

Ivatury

White

et al. 2016

Clinics in Colon and Rectal Surgery

267

362

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Intussusception is defined as the invagination of one segment of the bowel into an immediately adjacent segment. The intussusceptum refers to the proximal segment that invaginates into the distal segment, or the intussuscipiens (recipient segment). Intussusception, more common in the small bowel and rarely involving only the large bowel, has historically presented as small bowel obstruction, although there is an increasing appreciation of cases of transient, asymptomatic intussusception within the era of abdominal CT scans. The natural history of intussusception starts with a lead point, typically neoplastic (such as lymphadenopathy, polyp, or cancer), which acts as a focal area of traction that draws the proximal bowel within the peristalsing distal bowel. Symptoms occur due to continued peristaltic contractions of the intussuscepted segment against the obstruction. With continued invagination resulting in edema, eventually the vascular flow to the bowel becomes compromised, resulting in ischemia to the affected segment that, left untreated, can result in necrosis and perforation.In the pediatric population, ileocolic intussusception is the most common type. The etiology of intussusception in children is typically idiopathic, often influenced by anatomic or infectious factors (►Table 1). The diagnosis and management in this population generally starts with nonoperative reduction of the intussusceptum using air or contrast enemas.In the adult population, intussusception is frequently due to a pathologic lead point, which can be intraluminal, mural, or extramural. As opposed to the pediatric population, the treatment of intussusception causing obstruction in adults typically involves surgery, often with bowel resection. Keywords AbstractIntussusception is defined as the invagination of one segment of the bowel into an immediately adjacent segment of the bowel. Idiopathic ileocolic intussusception is the most common form in children and is typically managed with nonoperative reduction via pneumatic and/or hydrostatic enemas. In the adult population, intussusception is uncommon and occurs more often in the small intestine than in the colon. It is associated with lead point pathology in most symptomatic cases presenting as bowel obstruction. When lead point pathology is present in adult small bowel intussusception, it is usually benign, though when malignant it is most frequently due to diffuse metastatic disease, for example, melanoma. In contrast, adult ileocolic and colonic intussusception lead point pathology is most frequently primary adenocarcinoma when malignant. The diagnosis is typically made intraoperatively or by cross-sectional imaging. With increasingly frequent CT/MRI of the adult abdomen in the current era, transient and/or asymptomatic intussusceptions are increasingly found and may often be appropriately observed without intervention. When intervention in the adult population is warranted, usually oncologic bowel resection is performed due to the association with lead point pathology.

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Section: Clinical Presentationmentioning

confidence: 99%

Section: Patient Evaluationmentioning

confidence: 99%

Intestinal Intussusception: Etiology, Diagnosis, and Treatment

Marsicovetere

Ivatury

White

et al. 2016

Clinics in Colon and Rectal Surgery

267

362

View full text Add to dashboard Cite

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“…Successful endoscopic resection has been reported for benign lesions causing intussusception,13 but should be dealt with caution due to increased risk of complications. Minimal invasive surgery for resection of the involved segment is also possible in expert hands, decreasing the pain and hospital stay 14…”

Section: Discussionmentioning

confidence: 99%

Adult with intestinal malrotation and colocolic intussusception: an unusual combo

Gandhi¹,

Pai

Kashiva

et al. 2019

BMJ Case Rep

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Intestinal malrotation is a congenital anomaly that results from an abnormality in the rotation and fixation of the gut as it returns to the abdominal cavity during development. Intussusception is a condition characterised by telescoping of one segment of the bowel into another segment. The combination of malrotation and intussusception is frequently a cause of intestinal obstruction in the paediatric age group. The coexistence of these two conditions is termed as Waugh syndrome and is uncommon in adults. We share our experience with an elderly woman who was admitted with diarrhoea and anaemia. Investigations revealed a large colonic polyp, colocolic intussusception and malrotation. The adenomatous polyp and mobile right colon would have lead to intussusception. The diagnosis was based on the findings of colonoscopy and contrast-enhanced CT scan of the abdomen. She was managed with a transverse colectomy with an uneventful recovery.

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“…En los adultos, la presentación clínica de la invaginación intestinal es más inespecífica y rara vez se presenta con la tríada clásica de dolor abdominal, masa palpable y heces sanguinolentas (18). Por el contrario, suele presentarse con síntomas de obstrucción intestinal.…”

Section: Presentación Clínicaunclassified

Intususcepción intestinal en la población pediátrica vs. población adulta

Mora

Daly

2020

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La intususcepción intestinal se define como la invaginación de un segmento del intestino en un segmento inmediatamente adyacente. Su forma más frecuente en la población pediátrica es la intususcepción idiopática de tipo ileocólica, la cual es considerada una de las urgencias abdominales más frecuentes. Ésta es tratada de manera general por medio de una reducción no quirúrgica, tal como un enema neumático y/o hidrostático. En la población adulta, por su parte, la presencia de intususcepción es poco común y ocurre con mayor frecuencia en el intestino delgado que en el colon. En la mayoría de los casos en esta población, la intususcepción se asocia con un punto pivote patológico que provoca la presencia de síntomas de obstrucción intestinal. Generalmente, la invaginación a nivel de intestino delgado tiene una etiología benigna, aunque cuando es maligna se asocia con mayor frecuencia a una enfermedad metastásica difusa. Por el contrario, la etiología maligna en la invaginación intestinal de tipo ileocólica y colónica se encuentra con mayor frecuencia asociada a un adenocarcinoma primario. De manera general, su diagnóstico se realiza de forma intraoperatoria o mediante imágenes transversales, tales como TAC o RMN del abdomen, permitiendo diagnosticar más fácilmente las intususcepciones asintomáticas y/o transitorias, las cuales pueden observarse adecuadamente sin ninguna intervención. Por su parte, en los casos que este justificada la intervención quirúrgica en la población adulta, se realiza una resección intestinal de tipo oncológico, esto debido a la frecuente asociación con malignidad de la intususcepción en dicho grupo de edad.

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Intestinal intussusception in a young women: unusual cause and specific management

Cited by 14 publications

References 15 publications

Intestinal Intussusception: Etiology, Diagnosis, and Treatment

Intestinal Intussusception: Etiology, Diagnosis, and Treatment

Adult with intestinal malrotation and colocolic intussusception: an unusual combo

Intususcepción intestinal en la población pediátrica vs. población adulta

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