Intussusception in an adult after colonoscopy

Yamazaki, Toshiyuki; Okamoto, Hiroyuki; Suda, Takeyasu; Sakai, Yasuo; Hatakeyama, Katsuyoshi; Hokari, Ichiro; Toyoda, Seiichi; Souma, Takeshi

doi:10.1016/s0016-5107(00)70371-3

Cited by 17 publications

(22 citation statements)

References 2 publications

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“…One case of ileocolic intussusception after endoscopic removal of 2 small adenomas, 1 case of cecocolic intussusception after ileocolonoscopy for human immunodeficiency virus-related diarrhea, and 1 case of colocolonic intususception after colonoscopy for chronic diarrhea. [4][5][6] In these cases, in contrast with the present one, there was no identified lead point for intussusception. In our case, one could speculate that the aspiration of the insufflated air while withdrawing the colonoscope, coupled with the ongoing propulsive peristalsis of small intestine folds that have already become telescoped over the colonoscope and relaxation of the ileocecal valve due to distention of the terminal ileum, led to invagination of the ileal polyp through the iliocecal valve.…”

Section: Discussioncontrasting

confidence: 90%

Ileocolic Intussusception Precipitated by Diagnostic Colonoscopy

Lasithiotakis

Grisbolaki

Filis

et al. 2012

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Only 5% of all cases of intussusceptions occur in adults. Intussusception complicating colonoscopy is an extremely rare event. Herein, we present a case of a 58-year-old man who developed ileocolic intussusception after a colonoscopy during which an adenomatous polyp was discovered in the terminal ileum. Eight hours after colonoscopy, the patient developed diffuse abdominal pain associated with vomiting and bloody diarrhea. A contrast-enhanced abdominal computed tomography scan revealed features of mechanical intestinal obstruction and a round soft tissue mass inside the right colon, followed by the wall of the intussusceptum. Emergency laparotomy revealed extended ileocecal intussusception with the polyp incarcerated by the ileocecal valve. A typical right hemicolectomy was performed, and the patient had an uneventful recovery. Histologic examination of the surgical specimen revealed an inflammatory fibroid polyp. Ileocolic intussusception due to an ileal polyp may be precipitated by colonoscopy and should be included in the differential diagnosis of acute abdomen after colonoscopy.

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Section: Discussioncontrasting

confidence: 90%

Ileocolic Intussusception Precipitated by Diagnostic Colonoscopy

Lasithiotakis

Grisbolaki

Filis

et al. 2012

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Only three cases of adult colo-colonic intussusception following colonoscopy have been reported [21-23]. However, there have been no reported cases of small bowel intussusception presenting after colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…However, there have been no reported cases of small bowel intussusception presenting after colonoscopy. A proposed mechanism for the pathogenesis of idiopathic (or iatrogenic) intussusception in adults post-colonoscopy is hyperperistalsis, which leads to venting of gas and emptying of the insufflated colon after colonoscopy [21]. Another possibility is that intussusception may be induced by post-polypectomy mucosal edema acting as a lead point [22].…”

Section: Discussionmentioning

confidence: 99%

Colonoscopy Leads to A Diagnosis of A Jejunal Gastrointestinal Stromal Tumour (GIST)

et al. 2011

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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal (GI) tract, but are the least common of small intestinal malignant neoplasms. While GI bleeding is the most common clinical presentation of GISTs, intussusception and obstruction are uncommon, as GISTs rarely grow into the lumen. We describe an unusual case of a 50-year-old male who presented with intermittent obscure, overt GI bleeding requiring multiple hospital admissions and blood transfusions. His work-up included abdominal CT imaging, small bowel follow-through, gastroscopies, push enteroscopy, colonoscopies, and anterograde and retrograde double-balloon enteroscopies. Complicating his presentation were colonic angiodysplasias and the development of recurrent venous thromboembolism requiring anticoagulation. Within an hour after an apparently uncomplicated colonoscopy, he developed an acute abdomen secondary to a jejunal intussusception, which led to a laparoscopic small bowel resection and the diagnosis of a jejunal GIST. Given his GIST had no high-risk features, ongoing surveillance with abdominal CT imaging was arranged. This case illustrates the complex presentation and diagnostic difficulty of a jejunal GIST causing obscure, overt GI bleeding and this is the first reported case of a jejunal intussusception following colonoscopy. Due to its submucosal location, multiple endoscopic approaches had failed to diagnose the GIST prior to surgery.

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“…Colo-colonic intussusception in the adult is relatively rare and almost always secondary to a definable lesion. 1,2 In a literature review of 160 surgically diagnosed adult intussusceptions, 48% originated in the small bowel and 52% in the colon. 1 In contradistinction to these surgical series, a recent study 4 of adult intussusception detected by CT or MR imaging showed 88% of intussusceptions to be enteroenteric, with only 12% involving the colon.…”

Section: Discussionmentioning

confidence: 99%

“…Hyperperistalsis, which would vent gas and empty the insufflated colon after colonoscopy, is a suggested mechanism for the unclear pathogenesis of idiopathic intussusception in adults. 2 Intussusception is often not considered clinically in the differential diagnosis of adult patients with abdominal complaints after colonoscopy. With the widespread use of CT in the evaluation of nonspecific abdominal pain, the diagnosis is nowadays most often made by the radiologist, because the CT features of intussusception are virtually pathognomonic.…”

Section: Discussionmentioning

confidence: 99%