RESUMEN
INTRODUCTION AND IMPORTANCE: Intussusception is described as invagination of a segment of the bowel into the lumen of an adjacent segment. Although it is the most frequent cause of intestine obstruction during childhood, it is unusual in adulthood, where intussusception represents 1% of all intestine obstructions and 5 % of all intussusceptions. CASE PRESENTATION: A 64-year-old female presented with a history of weight loss, intermittent diarrhea, and occasional transrectal bleeding. An abdominal computed tomography (CT scan) was performed showing a neoproliferative appearance and associated intussusception of the ascending colon. Colonoscopy revealed an ileocecal intussusception and a tumor on the ascending colon. Right hemicolectomy was performed. Histopathological findings were consistent with colon adenocarcinoma. CLINICAL DISCUSSION: Adults have an organic lesion within the intussusception in up to 70 % of cases. The clinical presentation of intussusception can vary significantly between children and adults, who will often exhibit chronic nonspecific symptoms including nausea, changes in bowel habits, and gastrointestinal bleeding. The imaging diagnosis of intussusception is a difficult subject, the basis for the diagnosis is a high index of clinical suspicion and noninvasive techniques. CONCLUSION: Intussusception is an extremely rare condition in adults, in this age group, the malignant entity is one of the main etiologies. Intussusception continues to be a rare entity and should be considered as a differential diagnosis of chronic abdominal pain and intestinal motility disorders; the treatment of choice continues to be surgical.
RESUMEN
Es una vasculopatía caracterizada por calcificación de la capa media de los vasos y proliferación de la íntima de los mismos, asociado a fibrosis y trombosis luminal, llevando a necrosis de los tejidos circundantes, en especial de los tejidos blandos. La fisiopatología de la calciflaxis está relacionada con múltiples factores, siendo una condición que lleva a la calcificación vascular acelerada y que se ha asociado a una serie de factores de riesgo como la enfermedad renal crónica en terapia de reemplazo y en trasplante renal. Se han relacionado otros factores no urémicos como son anormalidades en el metabolismo del calcio, hiperparatiroidismo primario, estados de hipercoagulabilidad como malignidad, déficit de proteína C y S, hepatopatía alcohólica, terapia con warfarina, hipoalbuminemia, terapias con calcio y vitamina D, obesidad y producto calcio/fósforo superior a 70. A continuación se reporta el caso de una paciente a quien se le documenta un cuadro clínico de calciflaxis, describiendo la presentación clínica de esta patología, los factores de riesgo identificados y las complicaciones presentadas durante su atención (Acta Med Colomb 2011; 36: 149-152).
Calciphylaxis is a vasculopathy characterized by calcification of the tunica media and proliferation of the tunica intima of blood vessels, in association with fibrosis and thrombosis of the lumen, which lead to necrosis of surrounding (especially soft) tissues. The pathophysiology of calciphylaxis is related with multiple factors. This condition leads to accelerated vascular calcification and has been associated with a number of risk factors, such as chronic renal disease, kidney replacement therapy, and renal transplantation. It has also been related with other, non-uremic, factors, such as calcium deregulation, primary hyperparathyroidism, hypercoagulability states (such as malignancy and deficiency of proteins C and S), alcoholic hepatopathy, warfarin therapy, hypoalbuminemia, therapy with calcium and vitamin D, obesity, and a Calcium/Phosphorus product above 70. We report the case of a patient with calciphylaxis by describing the clinical presentation, the associated risk factors, and the complications seen during the care of the patient (Acta Med Colomb 2011; 36: 149-152).
