Small bowel intussusception and Enterobius vermicularis infestation in a 20-year-old woman.

A 20-year-old woman presented with abdominal pain and MRI findings of intussusception of the distal small bowel with no identifiable lead point and no visualisation of the appendix. A diagnostic laparoscopy succeeded in manually reducing the intussusception but was unable to find any candidate lead point. Intraoperatively, hyperperistalsis was observed throughout the small bowel which seemed prone to transient intussusception. Incidental appendectomy revealed an uninflamed appendix with Enterobius vermicularis (pinworm) infestation, the most common parasite present in appendectomy specimens worldwide. Although intussusception in young adults is an uncommon occurrence, the unique nature of this case is amplified by the concurrent finding of E. vermicularis infection of the appendix in an adolescent in western Canada, a phenomenon normally observed in paediatric populations with higher incidence in tropical areas. Although the mechanism of intussusception in this patient remains unclear, it is hypothesised that E. vermicularis colonisation acted as an irritant stimulating intestinal hypercontractility with resulting intussusception. Successful medical eradication of the pinworm in this individual may prevent future recurrence.

Enterobius Vermicularis as a Cause of Intestinal Occlusion: How To Avoid Unnecessary Surgery.

Enterobius vermicularis may cause infections of the gastrointestinal tract and occurs approximately in 4% to 28% of children worldwide. It is most common in children aged 5 to 14 years.The most commonly reported symptoms are pruritus in the perianal region, abdominal pain, urinary tract infection, insomnia, irritability, salpingitis, and appendicitis, whereas intestinal obstruction is a very rare but would be considered to perform the right instrumental examination avoiding unnecessary surgical exploration.We report a case of an 8-year-old boy with an intestinal occlusion due to a colonic intussusception by Enterobius vermicularis managed conservatively.

Ileal intussusception due to a parasite egg: a case report.

Ileal intussusception is the invagination of the small intestine within itself and accounts for 1% of cases of acute obstruction. However, physicians do not initially consider intussusception as a possible diagnosis of obstruction due to its rarity in adults. Herein, we report the case of a 22-year-old male who was admitted to the Emergency Department with continuous abdominal pain. Ultrasonography and computed tomography revealed an ileal intussusception. The patient underwent surgical removal of the segment of the small bowel. Unexpectedly, pathology revealed that the invagination occurred due to a parasite egg, with features suggestive of Schistosoma species. Schistosomiasis, although considered a parasitic disease in tropical countries, is not absent from Europe and though it is highly improbable, it may be responsible for cases of intussusception in adults.

Oesophagogastric intussusception associated with spirocercosis in a dog.

An oesophagogastric intussusception was diagnosed in an intact Bull Terrier female aged 2 years and 7 months with a concurrent Spirocerca lupi infection. The dog was presented collapsed with a history of inappetance and lethargy of one day's duration. Anaemia and melaena were present on clinical examination. Thoracic radiographs did not reveal any significant findings. Abdominal ultrasound was suspicious for gastric pathology or a possible foreign body. The final diagnosis of an oesophagogastric intussusception with an S. lupi nodule at the cardia was made on post-mortem. Oesophageal intussusceptions are rare in dogs and often fatal. Gastro-oesophageal intussusceptions usually present with obvious radiographic signs in the caudal thorax, unlike an oesophagogastric intussusception, where the pathology lies within the abdomen and may not be readily diagnosed. Although spirocercosis often presents with a caudal oesophageal mass, this may not be seen radiographically. In this case, the two conditions were present together but the thoracic radiographs were normal.An oesophagogastric intussusception was diagnosed in an intact Bull Terrier female aged 2 years and 7 months with a concurrent Spirocerca lupi infection. The dog was presented collapsed with a history of inappetance and lethargy of one day's duration. Anaemia and melaena were present on clinical examination. Thoracic radiographs did not reveal any significant findings. Abdominal ultrasound was suspicious for gastric pathology or a possible foreign body. The final diagnosis of an oesophagogastric intussusception with an S. lupi nodule at the cardia was made on post-mortem. Oesophageal intussusceptions are rare in dogs and often fatal. Gastro-oesophageal intussusceptions usually present with obvious radiographic signs in the caudal thorax, unlike an oesophagogastric intussusception, where the pathology lies within the abdomen and may not be readily diagnosed. Although spirocercosis often presents with a caudal oesophageal mass, this may not be seen radiographically. In this case, the two conditions were present together but the thoracic radiographs were normal.

Chronic anisakidosis presenting with intestinal intussusception.

OBJECTIVE: Anisakidosis is a parasitic infection caused by the ingestion of row or uncooked fish, containing larval nematodes from the Anisakidae family. Intestinal anisakidosis represents about 4% of all cases, the majority being localized in the small bowel, with rare colonic involvement. Here we present an infrequent case of chronic anisakidosis, presenting with intestinal intussusception. CASE REPORT: A 52 years old woman, chronically treated with immunosuppressants, presented to our Institution with acute abdominal pain and vomiting, due to colocolic intussusception. Colonoscopy successfully reduced the intussusception and revealed the presence of a voluminous colonic submucosal mass, near the hepatic flexure. Therefore, the patient underwent laparoscopic right hemicolectomy. The diagnosis of anisakidosis was made when the histological examination of the surgical specimen revealed the infestation of the intestinal wall by a nematode of the Anisakidae family, with an intense erosive-inflammatory adjacent reaction.

Adult intussusception caused by Meckel's diverticulum complicated by anisakiasis of the small intestine: report of a case.

We report an extremely rare case of adult intussusception caused by Meckel's diverticulum complicated by anisakiasis of the small intestine. A 48-year-old female was admitted to our hospital with vomiting and abdominal pain 3 days after eating raw fish. The abdomen was distended with tenderness. Computed tomography demonstrated a target-shaped mass in the ileum and wall thickness of the distal ileum. We diagnosed intussusception and performed emergency surgery. At laparotomy, intussusception was already released. Since Meckel's diverticulum was observed at 40 cm and wall thickness was observed at 20 cm from the terminal ileum, we performed partial ileal resection including these lesions. On pathology, the anisakis body was found in the resected specimen of the ileum with wall thickness. The patient was discharged 8 days after surgery.

[Infectious etiology of acute idiopathic intussusception in children]. / Les étiologies infectieuses des invaginations intestinales aiguës idiopathiques chez l'enfant.

The intussusception (IIA) is an invagination of the immediate part of the intestine. She is responsible for a syndrome with an occlusive venous compression and swelling that can rapidly progress to intestinal necrosis. Most cases occur in children aged 6 to 18 months and occur more frequently in boys than girls. There are two types of IIA: the IIA idiopathic representing 90-95% of invaginations of the child and the IIA secondary to local injury of the gastrointestinal tract or occurring in a particular context whose frequency are between 5 and 10%. The pathogenesis of the IIA remains uncertain, but the infectious origin is criminalized in most idiopathic invaginations. This component is dominated by viral agents including adenovirus, rotavirus, enterovirus, human herpesvirus 6 and 7, cytomegalovirus and Epstein-Barrvirus. Bacterial agents are rather found and include Yersinia enterocolitica, Staphylococcus aureus, Escherichia coli O157, H7, Salmonella and Campylobacter. In a small proportion parasitic agents may be reported in the IIA, the most frequently found are Entamoeba histolytica, Trichuris trichuira, Ascaris lumbricoides, Ankylostoma and Giardia.

Intestinal schistosomiasis associated with intussusception: a case report.

We report a case of intestinal schistosomiasis associated with iliocaecal intussusception resulting from obstructions of the terminal part of the ileum by schistosome egg-induced fibrosis. A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of the terminal part of the ileum into the caecum, extending to the ascending colon. Hemicolectomy and end-to-end iliocolostomy was performed. Histological examination of the resected bowel revealed Schistosoma mansoni eggs within the mucosa, submucosa of the ileum, caecum and ascending colon, granulomatous inflammation with foreign body giant cells accompanied by fibrosis and eosinophilic infiltrate into the mucosa. Postoperatively, the patient recovered well. There may have been a synergistic effect of schistosomiasis with other underlying conditions, leading to intussusception. In conclusion, it is important to consider S. mansoni infection as a differential diagnosis for intestinal obstruction in endemic areas.

Intestinal anisakiasis can cause intussusception in adults: an extremely rare condition.

We report an extremely rare case of adult intussusception caused by anisakiasis. A 41-year-old man was admitted into our hospital for right lower abdominal colicky pain. Ultrasonography and computed tomography revealed the presence of intussusception. As pneumo-dynamic resolution by colonoscopy failed, surgery was performed. The anisakis body was found in the submucosal layer of the resection specimen. The patient was discharged 9 d after the operation. Anisakiasis may cause intussusception in any country where sushi or sashimi now exists as a popular food. If suspicious, detailed clinical interview as to food intake prior to symptom development is crucial.

Ascaris as a leading point for small-bowel intussusception in an adult: a rare cause of intussusception.

Adult intussusception represents 1% of patients with bowel obstructions and requires a surgical approach. Malignancy is associated with 31% of small bowel intussusception and 70% of large bowel intussusception. Intestinal intussusception caused by ascaris, however, is very uncommon. This report describes our experience of this rare cause of intussusception and its clinical findings.

Caecal-caecal intussusception caused by Trichuris trichiura in a young healthy adult.

Trichuris trichiura is a worldwide problem affecting millions of people. We report an unusual case of intussusception caused by T. trichiura that mimics acute appendicitis. The literature on T. trichiura associated intussusception is reviewed.

Intussusception due to intestinal anisakiasis: a case report.

This report describes our experience of intussusception due to intestinal anisakiasis which was treated by laparoscopy-assisted surgery. The unique sonographic findings of this complication were a pseudokidney sign and a target sign with an edema of Kerckring's folds in the intussusceptum. Surgeons should know about intussusception as a rare complication of intestinal anisakiasis. Sonography, computed tomography and laparoscopy are helpful in diagnosing and treating this complication.

Caecocaecal and caecocolic intussusceptions associated with larval cyathostomosis in four young horses.

This report describes the clinical and pathological features of 4 horses affected by caecocaecal or caecocolic intussusceptions associated with larval cyathostomiasis. In each case, there was clinical and/or pathological evidence of concurrent larval cyathostomosis. They all demonstrated variable signs including diarrhoea, pyrexia, weight loss and subcutaneous oedema and cyathostome larvae were identified in the faeces of 3 of the horses. These cases highlight the need to consider caecal intussusceptions as a possible complication in horses affected by larval cyathostomosis, especially where signs of abdominal pain are severe or persistent.