Rare case of adult jejunojejunal intussusception secondary to angiolipoma

Chacko, Jupin; Tran, Gary; Vossoughi, Farhad

doi:10.1136/bcr-2014-209126

Cited by 6 publications

(10 citation statements)

References 23 publications

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“…We identified 27 cases of GI angiolipoma reported in the English language ( Table 1 ); including our 3 cases, there were 30 cases. Among these 30 cases, 9 (30.00%) were located in the colon, 10 – 15 7 (23.33%) in the ileum, 16 – 20 4 (13.33%) in the stomach, 5 , 21 – 23 2 (6.67%) in the esophagus, 24 , 25 2 (6.67%) in the duodenum, 6 , 26 2 (6.67%) in the rectum, 27 , 28 2 (6.67%) in both the duodenum and colon, 26 , 29 1 (3.33%) in the jejunum, 30 and 1 (3.33%) in the cecum. 31 The 30 patients comprised 20 men and 10 women.…”

Section: Resultsmentioning

confidence: 99%

Rare localization of angiolipoma in the gastrointestinal tract: a case series

et al. 2020

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Objective Angiolipoma is a benign tumor that rarely occurs in the gastrointestinal (GI) tract. This case series was performed to increase clinicians’ understanding of the diagnosis and management of GI angiolipoma. Methods We evaluated the clinical presentations, diagnoses, and treatments of 3 patients with angiolipoma in the upper GI tract in our hospital and 27 cases reported in the literature. Results Among all 30 cases of GI angiolipoma, 2 originated in the esophagus, 4 in the stomach, 2 in the duodenum, 1 in the jejunum, 7 in the ileum, 1 in the cecum, 9 in the colon, 2 in the rectum, and 2 in both the duodenum and colon. Conclusion Angiolipoma of the GI tract may be more likely to occur in middle-aged and elderly men and be located in the ileum and colon. The clinical manifestations generally involve upper GI hemorrhage and lower GI pain and obstruction. Computed tomography and endoscopy may be effective diagnostic techniques, but postoperative histopathologic examination is still the gold standard. The management of angiolipoma in the GI tract depends on the size and type of lesion. Most cases in the present series were managed by complete surgical resection, after which no recurrence was found.

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Section: Resultsmentioning

confidence: 99%

Rare localization of angiolipoma in the gastrointestinal tract: a case series

et al. 2020

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“…The presence of a causative underlying lesion in most adult patients means that recurrence is highly likely, and thus, surgery will be necessary [ 3 ]. Given the rarity of AI and the absence of obvious clinical features, the diagnosis is often made radiologically [ 5 ]. Our case serves to highlight the importance of thoroughly investigating patients with recurrent gastrointestinal symptoms by cross-sectional imaging when their symptoms have not been satisfactorily explained by initial investigations, even in young patients where malignant pathology is felt to be unlikely.…”

Section: Discussionmentioning

confidence: 99%

“…Our case serves to highlight the importance of thoroughly investigating patients with recurrent gastrointestinal symptoms by cross-sectional imaging when their symptoms have not been satisfactorily explained by initial investigations, even in young patients where malignant pathology is felt to be unlikely. Recurrent presentations with crampy abdominal pain in adults unexplained by endoscopy or ultrasonography should raise suspicion of small bowel pathology, such as intussusception, which can be diagnosed on CT with a sensitivity of up to 87.5% and specificity of 100% [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in almost all cases, a small bowel resection was performed, even in the context of viable bowel, despite most yielding benign pathology [ 1–5 ]. Malignant small bowel tumors are rare, with small bowel AI most commonly being a result of benign lesions, such as lipomas, Peutz–Jeghers polyps and adenomatous polyps [ 5 ]. To our knowledge, our case is the first in the literature where an organ-preserving approach to lesion removal was used in AI, whereby an intraluminal lesion without suspicious features was removed via enterotomy.…”

Section: Discussionmentioning

confidence: 99%

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Ileoileal intussusception in the adult patient secondary to a fibroma: An organ-preserving approach to management

Hannan

Egan

Bell

et al. 2021

Journal of Surgical Case Reports

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We present a rare case of adult intussusception (AI) due to a small bowel fibroma, which presented as recurrent subacute symptoms. To our knowledge, this is the first reported case managed by intraluminal excision of the causative lesion by enterotomy as opposed to bowel resection. A 34-year-old woman presented with recurrent colicky abdominal pain. Computed tomography demonstrated ileoileal intussusception, with magnetic resonance imaging revealing a 2.3-cm intraluminal lesion acting as a lead point. The patient underwent laparotomy and the intussusception was reduced. Palpation of the lesion demonstrated a pedunculated polyp without suspicious features; so the lesion was resected via enterotomy as opposed to small bowel resection. Histopathological analysis diagnosed a benign fibroma. AI is a rare but important entity, with potentially devastating consequences for delayed diagnosis. The majority of lesions causing AI are benign and may be amenable to intraluminal resection via enterotomy, thus avoiding unnecessary bowel resection.

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“…Small intestinal intussusceptions are mainly caused by lesions in or outside the intestine, including adenomatous polyps, lipomas, stromal tumors, lymphoma, intestinal inflammation, Michael diverticulum, postoperative intestinal adhesions, adenocarcinoma, and metastatic carcinoma. Some rare lesions also occur, such as a neuroendocrine tumor, [ 9 ] angiolipoma, [ 21 ] myoepithelial hamartoma, [ 22 ] and appendiceal mucinous cystadenoma, [ 23 ] which have only been described in case reports. Adenocarcinoma accounts for approximately 30% of small intestinal intussusceptions, whereas colonic intussusceptions are mainly caused by malignant tumors.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal hemorrhage caused by adult intussusception secondary to small intestinal tumors

Sun²,

Song³

et al. 2018

Medicine

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Rationale:Adult intussusception is rarely observed, and the clinical manifestations are very atypical. The most common symptom is abdominal pain, while the incidence of hematochezia is relatively low. We report two cases of adult intussusception secondary to small intestinal tumors with gastrointestinal hemorrhage as the main symptom.Patient concerns:Two men aged 19 and 54 years were successively referred to our department due to intermittent hematochezia. The hemoglobin levels of the two patients declined progressively, and conservative treatment was ineffective.Diagnoses:The first patient underwent an abdominal computed tomography angiography examination, which showed that the intestine and its mesentery were tortuous, suggesting an intra-abdominal hernia or intussusception. The second patient underwent an abdominal computed tomography examination, which suggested a high possibility of an intussusception. The two patients were diagnosed as adult intussusception caused by small intestinal tumors.Interventions:Emergency laparoscopic explorations were performed. Enteroenteric intussusceptions caused by ileal tumors were found during surgery. Reduction of the intussusceptions and resection of the ileal tumors were performed.Outcomes:The patients recovered well after surgery, and postoperative pathology showed that the tumors were a vascular hamartoma polyp and a lipoma.Lessons:Adult intussusception is very rare, particularly with gastrointestinal hemorrhage as the main symptom. Isolated hamartoma polyp is a rare cause of intussusception in adults. The clinical manifestations of adult intussusception are very atypical, and thus, making a preoperative diagnosis is difficult. Abdominal CT or CTA is an effective diagnostic method for adult intussusception. For adult patients with gastrointestinal hemorrhage caused by intussusceptions, active surgery should be performed when conservative treatment is not effective. Laparoscopic surgery is a safe and effective treatment for adult intussusceptions caused by benign diseases.

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Rare case of adult jejunojejunal intussusception secondary to angiolipoma

Cited by 6 publications

References 23 publications

Rare localization of angiolipoma in the gastrointestinal tract: a case series

Rare localization of angiolipoma in the gastrointestinal tract: a case series

Ileoileal intussusception in the adult patient secondary to a fibroma: An organ-preserving approach to management

Gastrointestinal hemorrhage caused by adult intussusception secondary to small intestinal tumors

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