Adult intussusception : A 14-year retrospective study of clinical assessment and computed tomography diagnosis.

BACKGROUND AND STUDY AIMS: Intussusception in adults often remains unrecognized. Our aim was to report our experience with this entity to determine the usefulness of CT scan in its preoperative diagnosis. PATIENTS AND METHODS: The medical records and imaging studies of all patients ≥16 years of age with intussusception, who were managed at our hospitals, were retrospectively reviewed. RESULTS: 17 cases of adult intussusception (7 males, 10 females; mean age 35.9 years; age range of 16-78) were identified. The diagnosis was possible in all patients using CT scan. The underlying etiologies were colon cancer (n=2), lymphoma (n=2), small bowel polyps (n=2), jejunal lipoma (n=1), metastatic melanoma (n=1), Meckel's diverticulum (MD) (n=1) and idiopathic (n=1). In the remaining 7 patients, the intussusceptions were of the transitory form and were treated conservatively and no significant sequela occurred after a follow-up of 2-60 months. CT scan findings in transient cases characteristically showed that the intussusception was localized to the proximal intestine and all of them had a short segment (2-4 cm) of intussusception. CONCLUSIONS: The important role of the CT in the preoperative diagnosis of intussusception and characterizing its causes cannot be overemphasized. All transient cases had a short segment of intussusception.

Progressive pseudorheumatoid dysplasia: report of a family and review.

Progressive pseudorheumatoid dysplasia is an inherited skeletal dysplasia with radiographic changes notably in the spine, similar to spondyloepiphyseal dysplasia tarda. There is also articular cartilage involvement which gives it some clinical resemblance to rheumatoid arthritis. We report here on six subjects from one inbred family from Jordan. Based on previously published reports and this one, we review the clinical and radiological features and discuss the genetics and differential diagnosis of the disorder. We suggest the addition of the word "spondyloepiphyseal" to the name adopted by the International Working Group on Constitutional Diseases of Bone, to become "progressive pseudorheumatoid spondyloepiphyseal dysplasia". We also speculate on candidate genes for this disorder.

Infective endocarditis and occult splenic abscess caused by Brucella melitensis infection: a case report and review of the literature.

This report describes a patient with prosthetic aortic valve endocarditis caused by Brucella melitensis infection with an initial relapse after apparent recovery due to associated occult splenic abscess. In spite of a prolonged period of recovery (6 months) achieved with splenectomy and antibrucella antimicrobial therapy, a second relapse occurred and cure was achieved after replacement of the infected prosthetic valve and prolonged courses of antibrucella antimicrobial therapy. There is controversy on the optimal therapy of such cases, but this report suggests that successful management requires a combination of medical and early surgical therapy.