Transient small bowel intussusception in adults: an overlooked feature of coeliac disease

Briggs, James; McKean, David; Palmer, Jonathan; Bungay, Helen

doi:10.1136/bcr-2013-203156

Cited by 9 publications

(6 citation statements)

References 12 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, AI raises concern for tumors (≥65%) or other harboring pathology, whether intra-luminal or extra-luminal (e.g. diverticula, adhesions, polyps, celiac disease, Crohn’s disease) [ 4 , 5 ]. An unknown cause (primary or idiopathic) in adults has been reported up to 20% of the time.…”

Section: Discussionmentioning

confidence: 99%

Small bowel intussusception in marijuana users

Kakish

Alaoudi

Welch

et al. 2020

Journal of Surgical Case Reports

View full text Add to dashboard Cite

Intussusception occurs when one portion of bowel ‘telescopes’ into another due to a lead point created by a range of benign or pathologic process. Intussusception mostly occurs in children. Although adult intussusception (AI) is rare, accounting for <5% of intestinal obstructions, it is more concerning in adults as malignancy accounts for nearly 65% of lead points in AI. Patients present with severe abdominal pain concerning for an acute abdomen along with a degree of bowel obstruction. We have experienced a total of 11 patients within recent years presenting with symptoms of an acute abdomen due to AI. None of these patients were found to have a pathologic process creating a lead point. However, we found that all of them were marijuana users. In this report, we compare their management, hospital course and review of the literature discussing proposed mechanisms that suggest an association between cannabis and intussusception.

show abstract

Section: Discussionmentioning

confidence: 99%

Small bowel intussusception in marijuana users

Kakish

Alaoudi

Welch

et al. 2020

Journal of Surgical Case Reports

View full text Add to dashboard Cite

show abstract

“…The association between CD and idiopathic intussusception has first been demonstrated in 1968 by Ruoff et al [ 4 ]. Theories of adult intussusception development in CD are thought to invagination of one segment bowel loop into another due to dilated flaccid loops, disturbing normal peristaltic waves [ 5 ]. Sanders et al [ 6 ] found that 4.9 years is the mean time from the symptoms onset to diagnosis of CD.…”

Section: Discussionmentioning

confidence: 99%

Transient Small-Bowel Intussusception Unmasking Adult Celiac Disease

AlAhmad

Almessabi

2022

Case Rep Gastroenterol

View full text Add to dashboard Cite

Celiac disease (CD) is a chronic immune-mediated small-intestinal disorder. The tissue transglutaminase (TTG) antibodies test is the initial step in the diagnosis of CD. Intussusception is a process where one segment of the bowel invaginates into the lumen of an adjacent segment. Despite that, the association between adult intussusception and CD has been descried previously, and it is still not widely recognized. We report a case of adult intussusception as the first manifestation of CD. A 28-year-old nonalcoholic and nonsmoker, previously healthy man, presented to the emergency department with a 1-week history of progressive diffuse abdominal pain associated with abdominal distension, nausea, vomiting, diarrhea, and 7 kg weight loss. The physical exam was remarkable for thin body habitus with no lymphadenopathy. Laboratory testing was significant for hypochromic microcytic anemia, AST 214 IU/L, ALT 217 IU/L, alkaline phosphatase 183 IU/L, and INR 2.9. An abdominal radiograph showed distended gas-filled small- and large-bowel loops. An abdominal computed tomography scan with contrast was done and demonstrated a telescoping of the small bowel in at least 3 areas with a target sign appearance with no signs of obstruction that suggested small-bowel intussusception. Following this imaging result, the patient was admitted under general surgery and kept nothing by mouth. The surgical team approached the gastroenterology team for push enteroscopy with biopsy which the patient refused. Further investigation included TTG antibodies; IgA and IgG were significantly elevated, 4,965.5 CU and 431.9 CU, respectively (reference: <19.9 CU). The diagnosis of CD leading to adult intussusception was made. The patient was advised to start a gluten-free diet. During the hospital stay, the patient had complete resolution of his symptoms and was discharged home. In summary, this case highlights the potential link between adult intussusception and CD. Adult intussusception is a rare condition that its underlying etiology should be meticulously investigated to expedite treatment and prevent unnecessary surgical intervention.

show abstract

“… Briggs et al (2014) reported that adult intussusception patients are more common in males (male: female ratio 2.9:1) with an average onset age of 40 years. The data showed that there were more females than males, the ratio of males to females was 0.7 (1:1.4), and P > 0.05 indicated no statistical significance.…”

Section: Discussionmentioning

confidence: 99%

Adult intussusception: a challenge to laparoscopic surgery?

Sun

Shu

et al. 2022

PeerJ

View full text Add to dashboard Cite

Background Intussusception can occur at any age and is common in children but less common in adults. This study aimed to evaluate our experience of 51 adult intussusception and study the etiology, clinical manifestations, diagnosis, and treatment. Methods This analysis assessed the clinical manifestations, etiology, diagnosis, and treatment of adult intussusception in 51 adult patients at the Department of Gastrointestinal Surgery of China-Japan Union Hospital of Jilin University from January 2010 to December 2020. Results The mean age of the cohort was 54.43 ± 18.21 years, and 42 patients were diagnosed by abdominal ultrasonography and abdominal computed tomography (CT). Among them, 76.5% (39/51) had abdominal pain, 11.8% (6/51) had blood in stool, and 5.9% (3/51) had a palpable abdominal mass. Of these, 62.7% had tumors: malignant accounted for 39.2% (20/51) and benign accounted for 23.5% (12/51). CT is the preferred imaging method with a sensitivity of 92.2%, while colonoscopy provides a complementary diagnosis in patients involving the colon. All patients underwent surgical treatment, including 21.6% (11/51) laparoscopic surgery, 74.5% (38/51) open surgery, and 5.9% (3/51) intussusception reduction during the operation. The average operation time of the open group was 133.27 ± 43.75 min and the average hospital stay was 16.24 ± 12.55 days, while the average operation time of the laparoscopic group was 140.50 ± 46.15 mins, and the average hospital stay was 16.60 ± 16.98 days (P > 0.05). Conclusion Adult intussusception is a rare disease in clinic. Laparoscopic surgery can be useful and safe for adult intussusception.

show abstract

Transient small bowel intussusception in adults: an overlooked feature of coeliac disease

Cited by 9 publications

References 12 publications

Small bowel intussusception in marijuana users

Small bowel intussusception in marijuana users

Transient Small-Bowel Intussusception Unmasking Adult Celiac Disease

Adult intussusception: a challenge to laparoscopic surgery?

Contact Info

Product

Resources

About