“Twist &amp; Slide” Bowel Obstruction: Two Different Rare Causes of Adult Bowel Obstruction in the Same Patient

Raet, Jan De; Brugman, Thomas M.; Geukens, A

doi:10.1080/00015458.2006.11679963

Cited by 2 publications

(6 citation statements)

References 7 publications

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“…Even more rarely, another acute condition, namely ileocaecal or ileocaecal-colonic intussusception (ICI) in various degrees, may coexist with adult MGM. ICI is facilitated by the caecocolic mobility and the altered peristaltic bowel motion, the increase value in intraluminal pressure, and even the presence of a demonstrable ileocolic structural lesion( identified in 90% of cases), that serves as a ''lead point'' for (asymmetrical) invagination and it is neoplastic in up to 75% of cases , mostly malignant (synchronous "slide and twist" process) 3,4,9,11 . Similarly, ICI can result in obstruction and subsequent bowel ischaemia 9 .…”

Section: Pathophysiologymentioning

confidence: 99%

“…Similarly, ICI can result in obstruction and subsequent bowel ischaemia 9 . Some hypotheses explaining the coexistance of ICI and RCV in rare adult cases are found in the relative literature 3,11 , but possibly the exact mechanism is not quite understood.…”

Section: Pathophysiologymentioning

confidence: 99%

“…Finally, CT scan usually demonstrates the hallmarks "bowelwithin-bowel" and "target lesion" of ICI (Fig. 1), which however is less specific if there has been ischaemia and perforation 3,11 . Delayed diagnosis of MGM is common in several case reports describing atypical presentations of left-sided acute appendicitis 12 .…”

Section: Presentation and Diagnosismentioning

confidence: 99%

“…Some patients may present chronically with nonspecific symptoms (i.e. vague abdominal pain) or recurrent intermittent bowel obstruction, and a minority with acute or fulminating bowel obstruction due to caecocolic mobility and torsion or even bowel invagination,which may lead to bowel necrosis 3,[8][9][10][11] . Adult caecocolic torsion is a class of right colon volvulus (RCV), and MGM is always associated with an increased risk of this devastating complication 4,7,9 .…”

Section: Introductionmentioning

confidence: 99%

“…Adult caecocolic torsion is a class of right colon volvulus (RCV), and MGM is always associated with an increased risk of this devastating complication 4,7,9 . The more rare bowel invagination in cases with underlying MGM, namely ileocolonic intussusception (ICI), may present independently or coexisting with RCV 3,9,11 .…”

Section: Introductionmentioning

confidence: 99%

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Complicated Adult Midgut Malrotation: A Challenge to Diagnose and Treat

Avgoustou¹

2019

wjoncgy

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Midgut malrotation (MGM) refers to a broad spectrum of rotation and fixation anomalies of the gut during fetal development, which are clinically evident mostly early in life as newborn emergencies and rarely later as milder forms in adults. Most commonly, adult patients are asymptomatic throughout life or they are insidiously presenting unspecific symptoms for a significant period of time before the diagnosis is made. Less commonly, adult MGM cases are acutely complicated with challenging and life-threatening conditions, such as the obstructive midgut or right colon volvulus and the ileocolonic intussusception, which require prompt diagnosis, intensive resuscitation and emergent surgical intervention. Intentionally, high index of suspicion and awareness are essential, if bowel infarction is to be prevented and high morbidity and mortality reduced.

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