Adult ileo-ileal intussusception caused by inflammatory fibroid polyp leading to small bowel obstruction: a case report with comprehensive literature review.

Ileo-ileal intussusception, an infrequent cause of small bowel obstruction in adults, can be initiated by inflammatory fibroid polyps. These are uncommon, benign submucosal lesions of the gastrointestinal tract. This case report explores an adult patient with inflammatory fibroid polyps-induced ileo-ileal intussusception.

Submucosal Lipoma-Induced Small Bowel Intussusception: A Case Study of Surgical Intervention and Management in an Adult Female.

We present an adult patient, a 39-year-old female, with chief complaints of pain in the umbilical region. The patient was further evaluated by radiological investigations and was diagnosed with small bowel intussusception caused by submucosal lipoma as the lead point. She had undergone ileal resection and anastomosis of the affected segment. The postoperative period was uncomplicated, and the patient continued with regular oral intake. The histopathological analysis revealed it to be adipose tissue with no features of atypia. This case shows the rare presentation of small bowel intussusception due to a submucosal lipoma. It emphasizes the significance of diagnostic imaging tools for diagnosis and the need for surgery for proper administration.

Pivotal Surgical Intervention for Pediatric Ileoileal Intussusception With Meckel's Diverticulum: A Case Report.

The most prevalent congenital gastrointestinal tract abnormality is Meckel's diverticulum. It is discovered in most instances incidentally. It can be observed as painless bleeding in the gastrointestinal tract. However, it can occasionally result in acute intestinal obstruction, which frequently masks the actual clinical presentation. This is a case of a four-and-a-half-year-old male child who presented with features of obstruction, which, on further evaluation, revealed ileoileal intussusception. An emergency surgical intervention was planned with an exploratory laparotomy and a reduction of intussusception. This case emphasizes the urgency of diagnosing and managing intussusception to prevent serious consequences such as bowel ischemia, bowel necrosis, bowel perforation, peritonitis, and sepsis. It stands as a stark reminder for medical professionals to stay vigilant for these critical gastrointestinal emergencies, and immediate treatment with a multidisciplinary approach is recommended to significantly enhance patient outcomes.

Postoperative intussusception in children operated for primary intussusception - A very rare entity.

Postoperative intussusception (POI) after abdominal and non-abdominal operations is a rare but recognized condition discussed several times in literature. There are scarce reports regarding POI in children operated primarily for intussusception. We discuss three such cases that were seen in our institution in the last two years. The patients showed symptoms of atypical ileus that failed to resolve two to eight days following primary surgery. Ultrasound reported intussusception and surgical intervention was sought. All patients had ileoileal intussusception. Manual reduction was successful in two cases. One had intestinal necrosis and underwent resection and anastomosis. Recovery was satisfactory without recurrence. POI should be suspected in patients who show signs of intestinal obstruction in early postoperative period. A second POI should be kept in mind after surgical reduction of the first intussusception. Ultrasound should be performed to aid diagnosis followed by urgent surgical intervention.

Acute intestinal obstruction due to meckel's diverticulum: A case report and literature review.

Introduction: and Importance: Meckel's diverticulum is a rare congenital condition often detected incidentally. Meckel's diverticulum, a rare disease, may result in acute intestinal obstruction and is frequently misdiagnosed. This study aims to report a case of acute intestinal obstruction due to Meckel's diverticulum. Case presentation: A 61-year-old Javanese man was admitted to the emergency room with a history of constipation, nausea, vomiting, and abdominal pain. Physical examination showed abdomen distention, tenderness in the lower quadrant, and hyperactive bowel sound. Rectal examination found that the rectal ampulla was collapsed. A plain abdominal Radiograph showed small bowel dilatation and air-fluid levels. The patient was diagnosed with small bowel obstruction due to suspected left-sided colon cancer and taken up for exploratory laparotomy. Clinical discussion: On exploration, Meckel's diverticulum measuring 3.5 cm in length and with a 2 cm base was found about 70 cm proximal to the Bauhin valve; the thin part formed a band that entangled the small bowel. Ileo-ileal resection anastomosis was performed. Clinical discussion: Meckel's diverticulum is an intestinal pouch caused by incomplete obliteration of the vitelline duct during gestation. This condition affects 2 % of the population and is within 2 feet of the Bauhin valve. The mesodiverticular band was found to be the source of the bowel obstruction. Surgical resection is required for complicated diverticulum. Conclusion: Meckel's diverticulum can be difficult to diagnose and require a higher level of suspicion. Although Meckel's diverticulum is uncommon in adults, it should be considered a cause of small bowel obstruction.

Case Report: An unusual case of wide ileoileal intussusception associated with intestinal volvulus in a 8-months-old infant.

Introduction: Midgut volvulus and intussusception are prevalent paediatric abdominal emergencies. To the best of our knowledge, this is the first reported case of a connection between intestinal volvulus and a massive intussusception. Case report: An 8-month-old male infant was brought to the emergency room with a history of abdominal pain and vomiting for <24 h. On physical examination, the child appeared restless and was found to have a circumferential hard mass of approximately 4 cm in diameter in the epigastric region. Upon admission, laboratory results showed a C-reactive protein level of 0.4 mg/dl, LDH level of 351 U/L, mild leukocytosis with a white blood cell count of 12 × 103 /µl, and 67% neutrophils. A physical exam was significant for abdominal distention, hyperresonance in percussion, and a palpable, painful epigastric mass. The findings of the operation included a dilated and ischemic intestinal loop, approximately 25 cm from the ileocecal valve, twisted upon itself for three turns. After de-rotation, an extensive occluding ileo-ileal invagination with an ischemic intestinal loop was identified, and a length of approximately 55-60 cm of the distal ileum, including the ischemic segment, was resected. Discussion: This is the first reported case of a connection between intestinal volvulus and a massive intussusception. Currently, only two reported cases describe the connection between volvulus and intussusception, which are insufficient to establish a direct link between the two clinical conditions.

Ileo-ileal knot causing acute gangrenous small bowel obstruction: a case report.

BACKGROUND: Ileo-ileal knotting is a very rare cause of small bowel obstruction, and only a few reports have been published. Small bowel obstruction (SBO) is one of the most common emergency surgical conditions that require urgent evaluation and treatment and is one of the leading causes of emergency surgical admission. There are many causes of SBO that are known in general surgical practice, and these causes are different in the developing and developed worlds. CLINICAL PRESENTATION: In this article, we present a case of acute gangrenous SBO secondary to ileo-ileal knotting in a 37-year-old Ethiopian female patient after she presented with severe abdominal cramp, vomiting, and abdominal distension of 4 hours duration. The patient was operated on intraoperatively; she had gangrenous small bowel obstruction caused by ileo-ileal knotting. Later, the patient was discharged and improved after 12 days of hospital stay. CONCLUSION: Ileo-ileal knotting should always be considered in the differential diagnosis of acute small-bowel obstruction. The diagnostic difficulty and the need for urgent treatment of this condition to yield optimal results are discussed.

Solitary Fibrous Tumor of the Shoulder Metastasizing to the Small Intestine Presenting as Intussusception: A Case Report.

Solitary fibrous tumors (SFTs) are rare vascular malignancies that are rarely reported in the upper limb, and even rarer as secondary metastasis to the small bowel. We present a case of a 39-year-old male patient, a known case of metastatic SFT, presenting with severe abdominal pain and vomiting. Computed tomography showed ileo-ileal intussusception. Subsequently, he underwent surgical resection. Histopathological examination showed high-grade sarcoma of the intestinal wall, confirming small intestinal metastasis. This constitutes one of the rare cases of SFTs metastasizing to the small bowel, specifically to the ileum. A review of the literature on similar cases is presented. There appears to be a connection between upper limb SFT and bowel metastasis according to reported literature. However, the scarcity of similar reports makes the generalizability of the conclusion limited.

A Rare Case of Ileo-Ileal Knotting: A Case Report.

Small bowel obstruction due to ileo-ileal knotting is rare. Ileo-ileal knotting usually presents with clinical features of small bowel obstruction with rapid deterioration to bowel necrosis, and the management includes prompt surgical intervention. Here, we present a case of a 35-year-old patient who presented to our emergency room with severe non-radiating crampy abdominal pain for 18 hours. The patient underwent an emergency laparotomy as an intervention. Ileo-ileal knotting preoperative diagnosis is challenging due to its nonspecific presentation, the diagnosis is usually done intraoperatively, and the overall management of gangrenous ileo-ileal knotting is urgent laparotomy and en bloc resection of the gangrenous ileo-ileal knotting and anastomosis of the remaining viable bowel. If the bowel is viable, careful untying of the loops usually suffices. Ileo-ileal knotting should be considered in patients presenting with features of small bowel obstruction having rapid deterioration with signs of gangrenous bowel, and it requires urgent surgical intervention after adequate resuscitation.

Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report.

BACKGROUND: Intestinal knot formation is a condition wherein two segments of the intestine are knotted together; however, reports of small-intestinal ileo-ileal knot formation are rare. CASE PRESENTATION: The patient was a 62-year-old Asian male with a history of endoscopic colorectal adenoma resection and a spontaneous pneumothorax. The patient had no history of a laparotomy. He consulted his local doctor with the chief complaint of abdominal pain and was admitted to our hospital with suspicion of an acute abdomen. The abdomen had muscular guarding with tenderness and rebound tenderness. Contrast-enhanced computed tomography (CT) showed torsion of the mesentery of the small intestine with poor contrast filling. The patient was referred to our department with strangulated bowel obstruction and underwent an emergency laparotomy. Intraoperative findings revealed that two segments of the ileum were wrapped around each other to form a knot, and the strangulated small bowel was necrotic. After the release of the knot, partial resection of the small intestine was performed from 220 cm distal to the ligament of Treitz to 80 cm proximal to the cecum. The patient had a good postoperative course and was discharged on the 11th postoperative day. CONCLUSION: Ileo-ileal knots should be considered as part of the differential diagnosis when treating strangulated bowel obstruction.

A rare case report of viable ileo-ileal knotting of acute abdomen in adults.

INTRODUCTION: Regardless of the cause, bowel obstruction is described as the absence of abnormal transit of intestinal contents. It may involve only the small intestine, the large intestine, or both. It might be brought on by a bodily impediment or widespread modifications to the metabolism, electrolyte balance, or neuroregulatory systems. In the field of general surgery, there are several well-known causes that can vary between developing and developed nations. CASE PRESENTATION: In this case report, we describe a case of acute small bowel obstruction secondary to ileo-ileal knotting in 35 years old female patient with a complaint of crampy abdominal pain of 7 hour duration. She had associated frequent vomiting of ingested matter followed by bilious matter. She had also mild abdominal distention. She had history of caesarian section delivery 3 times the last time was 4 months back. CLINICAL DISCUSSION: Ileoileal knotting is a unique and rare clinical entity in which a loop of proximal ileum wrap around the distal part of ileum. The presentation includes abdominal pain and distension, vomiting, and obstipation. The majority of cases require resection and anastomosis or exteriorization of the affected segment, and management entails a high index of suspicion and emergent investigation. CONCLUSION: We demonstrate an instance of ileo-ileal knotting to highlight the fact that it is an unusual intraoperative finding and, given the rarity of cases, should be taken into account in the alternative diagnosis of patients exhibiting SBO signs and symptoms.

Ileoileal knotting as a rare cause of acute abdomen in adolescents: Case report.

INTRODUCTION: Knotting of bowel loops is a rare cause of acute abdomen and ileoileal knotting is one of the rarest causes, with only a few cases reported mostly in adult literature. CASE PRESENTATION: We describe cases of ileoileal knotting in 13 and 12-year-old male and female adolescents who presented with crampy abdominal pain, distension, and episodes of vomiting. Both had tachycardia and features of peritonitis. They were explored and gangrenous ileoileal knotting was found. After the knot was disentangled, the gangrenous portion was resected, and ileoileal and ileo-ascending anastomosis were performed respectively. After a smooth postoperative course, the patients were discharged home in good condition. CLINICAL DISCUSSION: The etiopathogenesis of ileoileal knotting is unknown, but speculative mechanisms are proposed, such as loaded bowel with longer mesentery, vigorous peristalsis, and a single bulky meal. The presentation includes abdominal pain and distension, vomiting, and obstipation. Management involves a high index of suspicion and emergent exploration with the majority requiring resection and anastomosis or exteriorization of the involved segment. CONCLUSION: We discuss these cases of Ileoileal knotting to emphasize that it is a usual intraoperative surprise given the paucity of cases. But sudden and severe abdominal pain and distension, and features of peritonitis in short duration may be considered clues for suspicion. Surgery is the mainstay of treatment and hence, the prognosis depends on early diagnosis and intervention as morbidity and mortality are very high because of the rapid progression to gangrene.

A Pediatric Case of Inverted Meckel's Diverticulum Presenting with Cyclic Vomiting-like Symptoms: A Case Report and Literature Review.

Asymptomatic Meckel's diverticulum cases are not uncommon, leading to diagnostic difficulties in cases of atypical presentations with only gastrointestinal symptoms other than bloody stool. A nine-year-old boy diagnosed as having cyclic vomiting because of recurrent abdominal pain and vomiting for 6 months was referred to our institute and hospitalized due to worsening symptoms. After admission, abdominal ultrasonography showed the multiple concentric ring sign and a pseudokidney sign at the lower ileum, leading to the diagnosis of ileo-ileal intussusception, but the gastrointestinal symptoms and ultrasonic findings disappeared spontaneously. Transanal, double-balloon, intestinal endoscopy demonstrated a pedunculated polyp-like structure, and surgical resection was performed. An inverted diverticulum was found in the resected intestinal lumen, and ectopic gastric mucosa was identified histologically, leading to the diagnosis of inverted Meckel's diverticulum. In pediatric cases involving periodic attacks of vomiting and abdominal pain, unnecessary emergent surgery could be avoided by cautious imaging evaluation and consideration of ileo-ileal intussusception with advanced lesions of an inverted Meckel's diverticulum as a differential diagnosis, without facilely diagnosing cyclic vomiting. In addition, previous reports of inverted Meckel's diverticulum were reviewed, and the results were compared between adult and pediatric groups in each category.

Unusual Presentation of Postoperative Intussusception in Two Infants.

We present two infants with postoperative intussusception following stoma formation for stricture bowel due to necrotizing enterocolitis. They had unusual clinical features which need a high index of suspicion to diagnose.

Retrograde Intussusception and Giant Meckel's Diverticulum: An Uncommon Encounter.

Retrograde intussusception (RINT) and giant Meckel's diverticulum (MD) are both rare pathologies and are seldom encountered in surgical practice. Thus, it is exceptional for both conditions to be seen in the same patient, with very few published case reports in the paediatric population. This case describes a three-month-old male who was referred to our paediatric surgery unit following a diagnosis of intussusception on an ultrasound scan. The patient presented to the paediatric emergency department one day prior with a clinical history of fever, cough, vomiting and irritability. After resuscitation, the patient was admitted for overnight observation in the paediatric ward. However, the patient's symptoms persisted with notable abdominal distension. Abdominal X-ray (AP erect) showed features of small bowel obstruction, while abdominal ultrasound showed a concentric mass in the right upper quadrant consistent with intussusception. Following this diagnosis of intussusception, pneumatic enema reduction under ultrasound guidance was attempted but proved unsuccessful. The patient was then taken for emergency laparotomy. At surgery, an ileo-ileal RINT with a proximal giant MD was discovered. Successful manual reduction of the RINT and wedge resection of the giant MD with primary ileo-ileal anastomosis was performed. The postoperative recovery and follow-up were uneventful.

Small intestinal myxoma presented with bowel obstruction, a rare case report.

INTRODUCTION: Myxomas are rare benign mesenchymal neoplasms and mostly occur in cardiac atrium and with lower prevalence, appear in sinonasal tract, gnathic bone, skin and joints. Benign primary tumors of the small intestine are quite unusual accounting about 3% of all the gastrointestinal tract neoplasms. PRESENTATION OF CASE: In this report, we present a rare case of small intestinal myxoma in a 43-year-old man complicated by ileoileal intussusception causing bowel obstruction. The patient underwent segmental resection of small bowel and the histopathologic evaluation confirmed the diagnosis of small intestinal myxoma. DISCUSSION: Among benign primary neoplasms of small bowel, Solitary intestinal myxomas are extremely rare mostly locate in submucosal layer of gastric, small bowel and rarely in cecum. To our knowledge only 9 cases of small bowel myxoma is reported in the literature so far. CONCLUSION: This case report aware surgeons and pathologists about rare occurrence of intestinal myxomas as a differential diagnosis of intussusception.

Inflammatory fibroid polyp (Vanek's tumor) causing double compound ileo-ileal intussusception in an adult patient, a case report.

INTRODUCTION AND IMPORTANCE: The majority of the of small bowel intussusception causes are benign, and different types of benign tumors have been reported as the lead points of an intussusception. Among these, some studies have reported inflammatory fibroid polyp as a cause of small bowel intussusception. However, according to our knowledge this is the first case to be reported in Africa of an adult double compound intussusception due to an inflammatory fibroid polyp. CASE REPORT: A 32-year-old female presented with epigastric abdominal pain, nausea, vomiting and diarrhea for 2 weeks. Investigations revealed a small bowel obstruction due to intussusception, and exploratory laparotomy was planned. CLINICAL DISCUSSION: Inflammatory fibroid polyp causing this unique feature of double compound ileo-ileal intussusception should be observed in adult patients who presents with intestinal obstruction. A CT scan is the diagnostic modality of choice, and we think that the disease is the first of its kind to be reported in Africa. CONCLUSIONS: Double ileo-ileal intussusception is a rare cause of intestinal obstruction in adult patients. INTERVENTIONS AND OUTCOME: Laparotomy reviled an ileo-ileal intussusception. After manual reduction of this intussusception, another intussusception was observed and containing a polyp. A clear margin resection and end-to-end primary anastomosis were performed. The histopathological report established the diagnosis of Inflammatory Fibroid Polyp. After the procedure, the patient's condition improved well with no complications. METHODS: This case report has been reported in line with the SCARE Criteria (Agha et al., 2020 [1]).

Combined Ileoileal and Ileocolic Intussusception Secondary to Inflammatory Fibroid Polyp in an Adult: A Case Report.

Intestinal intussusception is relatively rare in adults and accounts for approximately 5% of intestinal obstruction. Intussusception is classified into subtypes according to the location, including ileoileal, ileocolic, ileo-ileocolic, colo-colic, jejuno-ileal, or jejuno-jejunal; the ileocolic type being the most common. However, intussusception of a combination of different subtypes has rarely been reported in the available literature. Abdominal computed tomography (CT) is the most accurate tool to evaluate intestinal intussusception. The pathological lead point in the intestine typically results in adult intussusception. Surgical intervention is usually adopted in cases of adult intussusception due to a high incidence of underlying bowel malignancy. An inflammatory fibroid polyp (IFP) is one of the uncommon benign neoplasms of the gastrointestinal (GI) system, which can result in intestinal intussusception. Herein, we present a case of a 50-year-old female with combined ileoileal and ileocolic intussusception, which was initially diagnosed by abdominal CT. Therefore, laparoscopic right hemicolectomy surgery was performed, confirming the final diagnosis as ileoileal and ileocolic intussusception secondary to IFP.

Beneficiary Effect of Fibrin Glue on Healing of Ileoileal Anastomoses in Rats.

BACKGROUND/AIM: Intestinal anastomosis' integrity is crucial in surgery. This study aimed to investigate whether fibrin glue (FG) (a fibrin sealant containing human factor XII and fibrinogen) has a positive effect on the healing and the integrity of the ileoileal anastomosis in rats. MATERIALS AND METHODS: Twenty Wistar rats underwent enterotomy, ileoileal anastomosis and divided into four groups (A: complete anastomosis-no FG, B: complete anastomosis-FG, C: incomplete anastomosis-no FG, D: incomplete anastomosis-FG). Data included leak, adhesions, bursting pressure of the anastomosis, neoangiogenesis, and hydroxyproline levels. RESULTS: Angiogenesis was significantly higher in group B compared to group A (p=0.019). There were no significant differences between groups A and B regarding adhesions, hydroxyproline, and bursting pressure (p=0.500, p=0.158 and p=0.829, respectively). Hydroxyproline levels were higher in group D compared to C, but did not reach significance (p=0.098). CONCLUSION: Fibrin glue has a positive effect on ileoileal anastomoses. It is not entirely clear whether this effect is due to mechanical support or to the facilitation of the healing process or both. Further research is needed before FG can be applied to humans.