Intussusception in Adults: From Stomach to Rectum

Choi, Seung Hong; Han, Joon Koo; Kim, Se Hyung; Lee, Jeong Min; Lee, Kyung Ho; Kim, Young Jun; An, So Young; Choi, Byung Ihn

doi:10.2214/ajr.183.3.1830691

Cited by 97 publications

(80 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Benign tumors including lipoma, inflammatory fibroid polyp and hamartomatous polyp as well as malignant tumors such as lymphoma and ileal cancer, and Meckel's diverticulum have all been described as lead points for ileocolic intussusception (6). In our interesting case, the lead point was an enteric duplication cyst in the terminal ileum.…”

Section: Discussionmentioning

confidence: 70%

An ileal duplication cyst manifested as an ileocolic intussusception in an adult

Kim¹,

Sung²,

Park³

et al. 2015

Turk J Gastroenterol

View full text Add to dashboard Cite

An enteric duplication cyst presenting as enterocolic intussusception is an exceptional clinical entity. We herein report a rare case of an ileal duplication cyst that manifested as an ileocolic intussusception. A 19-year-old woman was hospitalized due to right upper quadrant pain. Colonoscopy revealed a polypoid mass protruding into the colonic lumen. Ultrasonography demonstrated intussusception with a teardrop-shaped cystic mass at the tip. Computed tomography also showed ileocolic intussusception with a 2.5 cm-sized round cystic mass at the tip of intussusceptum. Microscopically, the cystic wall consisted of a well-defined smooth muscle coat and heterotopic gastric mucosa, consistent with an enteric duplication cyst. This case highlights an ileal duplication cyst as an uncommon cause of adult ileocolic intussusception. To the best of our knowledge, this is the first case of enteric duplication cyst identified as a pathological lead point for enterocolic intussusception in an adult. Enteric duplication cysts should be included in the differential diagnosis of cystic-leading lesions for adult intussusceptions. Keywords: Enteric duplication cyst, enterocolic intussusception, adult INTRODUCTIONIntussusception occurs when a portion of the digestive tract becomes telescoped into the adjacent bowel segment. This condition usually occurs in children between 6 months and 2 years of age. In the past, intussusception was a severe condition with high morbidity and mortality rates. Currently, prompt diagnosis and effective treatment lead to a favorable outcome in most cases. Enteric duplication cysts are an uncommon congenital abnormality that manifest before 2 years of age in 80% of cases and that can occur anywhere along the gastrointestinal tract on the mesenteric side. The presenting signs and symptoms of enteric duplication cysts include abdominal distension, vomiting, bleeding, a palpable abdominal mass and urinary infrequency. The clinical manifestations are usually intestinal obstruction from adjacent pressure, volvulus and rarely intussusception (1). A thorough review of the literature revealed a few case reports of enteric duplication cysts causing enterocolic intussusception in infants (2-5); however, no such cases have been reported in adults to the best of our knowledge. We herein report a rare case of an ileal duplication cyst manifested as an ileocolic intussusception in a young adult woman. CASE PRESENTATIONA 19-year-old woman without medical or surgical history was hospitalized due to right upper quadrant pain. Physical examination revealed a tender palpable mass in the right upper quadrant of the abdomen. Laboratory results were within the normal range. Colonoscopy revealed a polypoid mass protruding into the colonic lumen ( Figure 1a). Ultrasonography (US) showed intussusception with a teardrop-shaped cystic mass at the tip, which had a double-layered wall consisting of a hypoechoic outer layer and an echogenic inner layer (Figure 1b). Computed tomography (CT) demonstrated ileocolic intussuscept...

show abstract

Section: Discussionmentioning

confidence: 70%

An ileal duplication cyst manifested as an ileocolic intussusception in an adult

Kim¹,

Sung²,

Park³

et al. 2015

Turk J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…BT'de mide antrumunun daralarak mide foldlarının antrumdan duodenuma uzanmış olması ve pilor kanalının genişle-yerek duodenumun prolabe mide ile dolmuş olması gastroduodenal intussepsiyon için tipiktir (5). Ayrıca bizim olgumuzda olduğu gibi endoskopik değerlendirmede midedeki submukozal lezyonun mide dokusu ile birlikte duodenuma prolabe olduğunun görülmesi tanıyı koydurur.…”

Section: Discussionunclassified

Recurrent Gastroduodenal Intussusception due to Gastric Gastrointestinal Stromal Tumors

Akyüz¹,

Torun²

2017

Clin Exp Health Sci

View full text Add to dashboard Cite

GİRİŞGastrointestinal stromal tümörler (GİST), gastrointestinal organların duvarındaki mezodermden köken alır ve gastrointestinal motilite dü-zenlenmesinde rol alan interstisyel Cajal hücrelerinden kaynaklanır. Gastrointestinal tümörlerin %1'inden azını oluşturmaktadır (1). GİST'lerin %60'ı midede, %30'u ince barsakta, %5'i duodenumda, %5'i rektumda, daha nadir olarak özefagus ve appendikste görülmektedir (1).Hastalığın ortaya çıkış şekli ve semptomlar tümörün yerine ve büyüklüğüne bağlıdır. GİST'lerin çoğu tanı anında asemptomatiktir. En çok görülen semptomlar kanama, karın ağrısı, bulantı ve kusmadır. Bulantı ve kusma daha çok tümörün bası etkisiyle pasajı tıkaması sonucu gelişir (2). Ancak çok nadiren bizim olgumuzda olduğu gibi, midedeki GİST'in duodenuma intussepsiyonu sonucunda da pasaj tıkanarak hastalık ortaya çıkabilir.Biz de çok nadiren GİST'e bağlı gelişen gastroduodenal intussepsiyon olgusunun tanı ve tedavisindeki deneyimimizi paylaşmayı amaçladık. OLGU SUNUMUBu çalışmada resimlerin ve hastaya ait bilgilerin, bilimsel içerikli toplantı ya da makalelerde kullanılabileceğine dair hasta bilgilendirilmiş ve onam alınmıştır.Altı aydır aralıklı bulantı ve kusma öyküsü olan 76 yaşındaki bayan hasta, son 3 gündür çok sayıda kusma ve epigastrik karın ağrısı şikayeti nedeniyle değerlendirildi. Özgeçmişinde 1 yıl önce dış merkezde endoskopi yapıldığı ve mide prepilorik yerleşimli 5x6 cm çaplı polipoid lezyon olduğu öğrenildi. Son 3 ayda 10 kilo kaybı olan hasta kaşektik görünümdeydi. Fizik muayenede epigastrik hassasiyet dışında patolojik bulgu saptanmadı. Laboratuvar değerlendirilmesinde üre 68 mg/dL, sodyum 130 mg/dL, potasyum 3 mg/dL idi. Hastaya sıvı replasmanı tedavisine başlandı. Üst GİS endoskopisi yapıldı ve mide küçük kurvaturun pilor içine prolabe olduğu görüldü. Duodenuma zorlanarak geçildiğinde duodenum içinde 5x5 cm ebatlarında, hafif iskemik submukozal lezyon saptandı ve endoskop tekrar mideye çekildiğinde reduksiyon ile pasajın AbstractGastrointestinal stromal tumors constitute less than 1% of gastrointestinal tumors (GISTs). Gastrointestinal stromal tumors most commonly occur in the stomach, small intestine, and duodenum and they rarely occur in the rectum and other organs. Manifestations of the disease and symptoms depend on the size and location of the tumor. These tumors may rarely cause intussusception. In this article, as less than 20 cases have been reported, we reported a case of gastroduodenal intussusception due to gastric GISTs and discussed the diagnosis and treatment of patients.

show abstract

“…3 is a schematic diagram that shows the longitudinal and serial cross-sectional views of an intussusception. (3) Patients with AI commonly present with nonspecific abdominal symptoms and features of intestinal obstruction that may have an acute, intermittent or chronic course. Only 9%-10% of adult patients present with the classic triad: acute colicky abdominal pain; passing of 'currant jelly' stool; and a palpable mass in the abdomen.…”

Section: Discussionmentioning

confidence: 99%