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1.
BMJ Case Rep ; 14(2)2021 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-33563694

RESUMO

Percutaneous cholecystostomy (PC) is a common minimally invasive, image-guided procedure performed primarily on high-risk patients with acute cholecystitis for gallbladder decompression. Herein, we present a case of a patient undergoing PC placement using a transperitoneal approach. On subsequent upsizing attempts, the gallbladder fundus was found to invaginate during advancement of replacement drains, causing gallbladder intussusception. The use of a balloon and locked pigtail catheter were required to reposition the gallbladder to proper position. The patient's planned percutaneous cholecystoscopy was delayed by 4 weeks until intended upsizing could be performed. This case demonstrates the advantage of achieving transhepatic gallbladder access to support tract formation and limit procedural complications.


Assuntos
Colecistite Aguda/cirurgia , Colecistostomia/métodos , Intussuscepção/etiologia , Intussuscepção/cirurgia , Idoso de 80 Anos ou mais , Colecistite Aguda/diagnóstico por imagem , Feminino , Fluoroscopia , Humanos , Intussuscepção/diagnóstico por imagem
2.
Niger J Clin Pract ; 24(2): 292-294, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33605922

RESUMO

Myxomas are slowly growing mesenchymal tumors and are considered as extremely rare benign tumors of small intestine. This is the case of a young woman presenting with acute bowel obstruction due to ileo-ileal intussusception caused by an intraluminal 4- cm solitary nodule, found to be a myxoma upon pathologic examination, after resection by surgery.


Assuntos
Doenças do Íleo , Obstrução Intestinal , Intussuscepção , Mixoma , Doença Aguda , Feminino , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Intestino Delgado , Intussuscepção/diagnóstico , Intussuscepção/etiologia , Intussuscepção/cirurgia , Mixoma/complicações , Mixoma/diagnóstico , Mixoma/cirurgia
3.
Gan To Kagaku Ryoho ; 48(1): 89-91, 2021 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-33468731

RESUMO

A 77-year-old woman, who underwent surgery for malignant melanoma of the nasal cavity 15 months prior and radiation and interferon-ß therapy for local recurrence, presented with epigastric discomfort. PET-CT examination showed multiple intussusceptions due to small intestinal tumors. Four intussusceptions were detected during laparotomy, and she underwent partial resection of the small intestine. Pathological findings revealed small intestinal metastases that originated from malignant melanoma. Following administration of nivolumab, local recurrence disappeared, and she was well. Because the prognosis of malignant melanoma with systemic metastases has improved due to the administration of new drugs, such as nivolumab, the incidence of indications for surgery for metastatic melanomas of the gastrointestinal tract is expected to increase.


Assuntos
Intussuscepção , Melanoma , Idoso , Feminino , Humanos , Intestino Delgado , Intussuscepção/etiologia , Intussuscepção/cirurgia , Melanoma/tratamento farmacológico , Cavidade Nasal , Recidiva Local de Neoplasia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
4.
Gan To Kagaku Ryoho ; 48(1): 142-144, 2021 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-33468748

RESUMO

The case is a 17-year-old man. He had complained of right lower abdominal pain for a week. He had no symptoms such as fever, weight loss, or night sweats. He was diagnosed with intussusception by abdominal contrast-enhanced CT and was hospitalized. The day after hospitalization, lower gastrointestinal endoscopy was performed, and a tumor 25 mm in size was found in the invagination of the ileum. Intussusception was recovered by intestinal scope insufflation, and the tumor was found to be a type 1 tumor located approximately 5 cm proximal to the Bauhin's valve. On day 17 of hospitalization, he had intussusception again at the time of surgery, and performed laparoscopic reduction before performing laparoscopy-assisted partial resection of the small intestine and appendectomy. The postoperative course was good and he was discharged on POD12(on day 29 of hospitalization). Histopathological diagnosis was diffuse large B-cell lymphoma(DLBCL), and chemotherapy was to be administered at the referral hospital. In intussusception of the adolescents and young adults(AYA)generation, such as this case outside of childhood, it is necessary to treat the patient with consideration for the presence of neoplastic lesions such as malignant lymphoma. We report our case with some literature considerations.


Assuntos
Doenças do Íleo , Neoplasias do Íleo , Intussuscepção , Adolescente , Apendicectomia , Criança , Características da Família , Humanos , Doenças do Íleo/etiologia , Doenças do Íleo/cirurgia , Neoplasias do Íleo/complicações , Neoplasias do Íleo/cirurgia , Íleo , Intussuscepção/etiologia , Intussuscepção/cirurgia , Masculino
5.
Orv Hetil ; 161(32): 1331-1338, 2020 08.
Artigo em Húngaro | MEDLINE | ID: mdl-32750021

RESUMO

Intussusception is one of the most common abdominal emergencies in children. The understanding of its aetiology and management has changed significantly over the last decades. Earlier, the hypertrophic Peyer's patches and polyps were considered responsible, but with the knowledge obtained from the lipopolysaccharide-induced animal model of intussusception, the rotavirus vaccination, the seasonality and the postnatal changes of the enteric nervous system it became clear that the intestinal motility plays a key role in the aetiology. The efficacy of non-operative management is continuously improving. The radiologists initially moved from the hydrostatic X-ray-controlled reduction towards the air enema (pneumatic reduction), however, nowadays, there is a shift back to hydrostatic procedures but under ultrasound guidance to reduce radiation exposure. In many institutions, intussusception is managed as day-case rather than as an inpatient case. The role of medications like glucagon and cyclo-oxygenase inhibitors used during reduction manoeuvres and prevention of recurrence is still controversial. Surgical management is shifting towards laparoscopy. The authors herein reviewed the current literature to present recent insights into understanding the pathogenesis and management updates. Orv Hetil. 2020; 161(32): 1331-1338.


Assuntos
Enema/métodos , Glucagon/uso terapêutico , Glucocorticoides/uso terapêutico , Obstrução Intestinal/diagnóstico por imagem , Intussuscepção/terapia , Laparoscopia , Ultrassonografia , Criança , Enema/efeitos adversos , Humanos , Lactente , Obstrução Intestinal/etiologia , Obstrução Intestinal/terapia , Intussuscepção/diagnóstico por imagem , Intussuscepção/cirurgia , Radiografia , Recidiva , Prevenção Secundária
6.
Gac. méd. espirit ; 22(2): 120-130, mayo.-ago. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1124841

RESUMO

RESUMEN Fundamento: La invaginación intestinal como causa de dolor abdominal es un motivo infrecuente de consulta en la edad adulta. Una lesión orgánica es la causante en el 90 % de los casos. Pueden ser lesiones malignas o benignas, y entre estas últimas se mencionan los lipomas de intestino delgado. Objetivo: Presentar el caso de una paciente con invaginación intestinal secundaria a pólipo mesenquimatoso. Presentación del caso: Paciente femenina de 47 años de edad, con antecedentes de dolor abdominal recurrente hacia fosa ilíaca derecha y cambios intermitentes en el hábito intestinal. En los estudios de imagen realizados se le diagnosticó una invaginación de intestino delgado, la cual se corroboró en el acto quirúrgico y mediante anatomía patológica que informó un pólipo mesenquimatoso (fibrolipoma) como causante. Conclusiones: La invaginación intestinal, aunque infrecuente, puede ser la forma de presentación de dolor abdominal recurrente en el adulto.


ABSTRACT Background: Intestinal invagination as a cause of abdominal pain is an infrequent reason for consultation in adulthood. An organic injury is the cause in 90 % of cases. They can be malignant or benign lesions, and among the latter, lipomas of the small intestine are mentioned. Objective: To present the case of a patient with intestinal invagination secondary to a mesenchymal polyp. Case presentation: A 47-year-old female patient with a history of recurrent abdominal pain towards the right iliac fossa and intermittent changes in bowel habit. In the imaging studies, an invagination of the small intestine was diagnosed which was corroborated in the surgical act and by pathological anatomy that reported a mesenchymal polyp (fibrolipoma) as the cause. Conclusion: Intestinal invagination, although infrequent, may be the form of presentation of recurrent abdominal pain in adults.


Assuntos
Dor Abdominal , Pólipos Intestinais/patologia , Intussuscepção/cirurgia , Adulto , Neoplasias do Íleo/cirurgia
7.
Arch. argent. pediatr ; 118(3): e338-e341, jun. 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1117378

RESUMO

La invaginación intestinal ocurre cuando un segmento proximal de intestino se repliega dentro de la luz de un segmento distal adyacente y provoca obstrucción intestinal. Es una causa común de abdomen agudo en los dos primeros años de la vida, pero raro en niños mayores. Un varón de 16 años, con diagnóstico de fibrosis quística, se presentó con un cuadro compatible con síndrome de oclusión intestinal distal. Consultó a la clínica con dolor abdominal y una masa palpable en el hipocondrio derecho. Se realizó ecografía abdominal y tomografía de abdomen contrastada, que demostraron invaginación íleo-colónica con signos de isquemia intestinal, necrosis y neumatosis de la pared intestinal. Fue intervenido: se realizó resección del íleon terminal y hemicolon derecho, y se detectó una tumoración en ciego. La invaginación íleo-colónica es una causa rara de abdomen agudo en pacientes adolescentes con fibrosis quística y puede estar asociada a una causa orgánica subyacente.


Intestinal intussusception occurs when a proximal segment of the intestine telescopes into the lumen of an adjacent distal segment, causing intestinal obstruction. It is a common cause of acute abdomen in the first two years of life, but rare in older children. A 16-year-old male with a diagnosis of cystic fibrosis presented with symptoms compatible with distal intestinal occlusion syndrome. He came at the cystic fibrosis clinic with a 5-day evolution of abdominal pain and a palpable mass in the right hypochondrium. Abdominal ultrasound and abdominal contrasted tomography were performed demonstrating ileo-colonic invagination with signs of intestinal ischemia, necrosis and pneumatosis of the intestinal wall. He underwent surgery with resection of the terminal ileum and right hemicolon, ana tumor in the caecum was found. This is a rare cause of acute abdomen in young patients with cystic fibrosis and may be associated with an underlying organic cause.


Assuntos
Humanos , Masculino , Adolescente , Fibrose Cística , Intussuscepção/diagnóstico por imagem , Dor Abdominal , Íleo/cirurgia , Obstrução Intestinal , Intussuscepção/cirurgia
8.
Vet Surg ; 49(5): 870-878, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32415881

RESUMO

OBJECTIVE: To describe perioperative characteristics and outcomes of dogs surgically treated for intestinal intussusception. STUDY DESIGN: Multi-institutional, retrospective study. ANIMALS: One hundred fifty-three client-owned dogs with intestinal intussusception. METHODS: Dogs were included when they had undergone surgical treatment of a confirmed intestinal intussusception. Medical records were reviewed for demographics and clinical data, including surgical complications (graded 1-4). Follow-up was obtained via telephone interview with owners and referring veterinarians. RESULTS: Dogs had a median age of 10 months (range, 2-156), and the most common location for intussusception was ileocolic (66/153 [43%]). Most cases had no identifiable cause (104/155 [67%]). Intestinal resection and anastomosis (IRA) was performed in 129 of 153 (84%) dogs; enteroplication was performed in 28 of 153 (18%) dogs, including 13 with and 15 without IRA. Intraoperative complications occurred in 10 of 153 (7%) dogs, all involving intestinal damage during attempted manual reduction. The median duration of follow-up after discharge was 334 days (interquartile range, 15-990; range, 1-3302). Postoperative complications occurred in 53 of 153 (35%) dogs, including 22 of 153 (14%) with severe (grade 3 or 4) events. Diarrhea, regurgitation, and septic peritonitis were the most common postoperative complications; intussusception recurred in four of 153 (3%) dogs, all within 72 hours postoperatively. Fourteen-day postoperative mortality rate was 6%. CONCLUSION: Surgical treatment of intestinal intussusception was curative in most dogs, even when an underlying cause was not identified. Surgical complications were common, including a 14% risk of life-threatening short-term complications. CLINICAL SIGNIFICANCE: Surgical treatment of intestinal intussusception offers an excellent prognosis, but the potential life-threatening complications should be considered.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/veterinária , Doenças do Cão/cirurgia , Complicações Intraoperatórias/veterinária , Intussuscepção/veterinária , Complicações Pós-Operatórias/veterinária , Anastomose Cirúrgica/veterinária , Animais , Cães , Feminino , Intussuscepção/cirurgia , Masculino , Recidiva , Estudos Retrospectivos
11.
J Ayub Med Coll Abbottabad ; 32(1): 9-12, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32468746

RESUMO

BACKGROUND: Intussusception is an acute surgical emergency and one of the most common causes of acute abdomen in early paediatric age group with peak incidence between 3 months to 3 years. It is considered the most common cause of intestinal obstruction in first two years of life. Early diagnosis and management may prevent major complications of bowel ischemia and necrosis thus avoiding morbidity and mortality. Our objective was to evaluate the risk factors or determinants of bowel resection in childhood intussusception. METHODS: It is a prospective, descriptive and cross-sectional study in which 102 consecutive cases of intussusception presenting to The Children's Hospital PIMS, from January 2018 to May 2019, were included. RESULTS: Total 102 patients were included in the study. Seventy-three (71.6%) were male and 29 (28.4%) were female. Mean age at presentation was 16.30 months (ranged from 1 day to 9 years). Mean duration of symptoms was 3.1 days. 52.9% (53/102) patients had mass palpable on abdominal examination while 22.5% (23/102) had palpable mass on digital rectal examination (DRE). Mean haemoglobin at presentation was 10.2 g/dL (min 4g/dL, max 26g/dL) and mean haematocrit was 32.6%. The most common type of intussusception was ileo-colic (57.8%) followed by ileo-ileal (21.6%). 36.3% (37/102) patients had to undergo bowel resection due to bowel gangrene/necrosis while in 66 (64.7%) patients had manual reduction. Statistically significant relationship was found between resection and duration of symptoms more than 24 hours (p=0.01, CI=95% OR= 6.24), haemoglobin less than 10g/dL (p=0.022, CI=95% OR=2.78) and haematocrit less than 30% (p=0.028, CI=95% OR=2.63). CONCLUSIONS: Prevention of anaemia and early presentation to a facility where trained paediatric surgeons are available can reduce the chances of bowel resection in childhood intussusception.


Assuntos
Doenças do Íleo/diagnóstico , Doenças do Íleo/cirurgia , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Criança , Pré-Escolar , Estudos Transversais , Procedimentos Cirúrgicos do Sistema Digestório , Feminino , Hematócrito , Humanos , Doenças do Íleo/complicações , Lactente , Recém-Nascido , Intussuscepção/complicações , Masculino , Necrose , Estudos Prospectivos , Fatores de Risco
15.
J Laparoendosc Adv Surg Tech A ; 30(5): 576-580, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32240037

RESUMO

Background: Laparoscopy has been widely used in treatment of pediatric intussusception. However, controversy still exists on the best surgical approach for children with multiple recurrences. This cohort study is aimed to compare the efficacy and safety of laparoscopic ileopexy versus laparoscopic simple reduction for treatment of ileocolic intussusception with three or more episodes of recurrence in pediatric patients. Patients and Methods: This study enrolled 74 children with three or more recurrences of ileocolic intussusception treated at our department between January 2016 and June 2018. Of these children, 37 cases undergoing laparoscopic ileopexy were matched with 37 cases undergoing laparoscopic simple reduction according to age. Data on patient characteristics, duration of follow-up, operative parameters, and recurrence rate after laparoscopic operation were reviewed and analyzed. Results: Patient characteristics, including age, gender, weight, number of recurrences at surgery, clinical manifestations, and duration of follow-up, were well comparable between the two groups (each P > .05). During follow-up, recurrence occurred in 16 (43.24%) children undergoing laparoscopic simple reduction, whereas recurrence occurred in 1 (2.70%) case undergoing laparoscopic ileopexy. In comparison, laparoscopic ileopexy significantly decreased the risk of recurrence (P < .001). No statistical difference was observed between the two groups in terms of operative time, length of postoperative stay, and intra- and postoperative complications (each P > .05). No morbidity was documented in both groups. Conclusions: Laparoscopic ileopexy is effective and safe as a surgical approach for multiple recurrences of ileocolic intussusception in pediatric patients. The underlying mechanisms are yet to be fully clarified.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Intussuscepção/cirurgia , Laparoscopia , Adolescente , Peso Corporal , Criança , Feminino , Humanos , Masculino , Duração da Cirurgia , Complicações Pós-Operatórias/cirurgia , Período Pós-Operatório , Procedimentos Cirúrgicos Reconstrutivos , Recidiva , Estudos Retrospectivos , Risco , Adulto Jovem
17.
J UOEH ; 42(1): 83-88, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32213746

RESUMO

A 68-year-old male with abdominal pain and vomiting was brought to our hospital by ambulance. Computed tomography showed multiple intussusceptions with pseudokidney signs in the jejunum and ileocecum, and a tumor of 5 cm in diameter in the left lower lobe of the lung. We performed an emergent operation, as a release of multiple intussusceptions was difficult by conservative treatment. There were two intussusceptions, in the jejunum and the ileocecum. We performed a partial resection of the jejunum and a resection of the ileocecum. Histopathological examination of the resected specimens and a biopsy specimen collected by bronchoscopy allowed us to diagnose multiple intussusceptions due to small intestine metastases from a pleomorphic carcinoma of the lung. This case is presented here, with a review of the literature.


Assuntos
Carcinoma/complicações , Carcinoma/secundário , Neoplasias Intestinais/complicações , Neoplasias Intestinais/secundário , Intussuscepção/etiologia , Neoplasias Pulmonares/patologia , Idoso , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Humanos , Intussuscepção/cirurgia , Masculino
18.
West Afr J Med ; 37(2): 118-123, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150629

RESUMO

BACKGROUND: Variable intestinal segments of children may need resection due to congenital or acquired conditions. Resection is done when these intestinal segments are nonviable or dysfunctional. In HICs most resections are for congenital conditions while in LMICs acquired and largely preventable conditions predominate.The spectrum of acquired intestinal conditions leading to bowel resection may also vary between HICs and LMICs. OBJECTIVES: To determine the indications, types and outcomes of intestinal resection for acquired conditions in children. METHODS: A retrospective review of pediatric bowel resections from acquired anomalies over a 10-year period in a tertiary hospital. Data entry and analysis done using SPSS. Fisher's exact test was used to assess level of significance for categorical variables and p-value of <0.05 was adjudged significant. Results are presented as means±SD, ratios, percentages and tables. RESULTS: Fifty-nine males and thirty-three females with a median age of 8 months were recruited. Complicated intussusceptions and right hemicolectomy were the most common indication and procedure respectively. Proportion of right hemicolectomies was more in infants than older children (p=0.0103) while ileal resection was higher in older children (p<0.001). Post-operative complications were seen in 35.8% and mortality rate was 8.7%. CONCLUSION: Complicated intussusception is the main acquired indication for intestinal resection. Right hemicolectomies and ileal resections were done mainly during infancy and beyond infancy respectively.


Assuntos
Colectomia/mortalidade , Doenças do Íleo/cirurgia , Enteropatias/cirurgia , Intussuscepção/cirurgia , Complicações Pós-Operatórias/mortalidade , Distribuição por Idade , Criança , Pré-Escolar , Colectomia/métodos , Feminino , Humanos , Doenças do Íleo/mortalidade , Lactente , Recém-Nascido , Enteropatias/complicações , Enteropatias/mortalidade , Intussuscepção/mortalidade , Masculino , Nigéria/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento
19.
Am J Case Rep ; 21: e920438, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32102989

RESUMO

BACKGROUND Intussusception is not very common in adults, and acute intestinal obstruction with intussusception due to inflammatory myofibroblastic tumor (IMT) is extremely rare. IMT is an uncommon lesion and has no single defined cause. It predominantly affects the pediatric age group and commonly involves the lungs. Here we present a case of IMT causing ileocolic intussusception leading to acute intestinal obstruction in an adult. CASE REPORT A 40-year-old female came to the emergency department with severe colicky pain in her abdomen, and reported 6 to 7 episodes of vomiting with bilious contents, along with an inability to pass feces and flatus for 3 days. An x-ray of her abdomen in erect posture revealed multiple air-fluid levels. Because she had a previous history of tuberculosis, a possible tubercular stricture as the cause of her acute obstruction was considered; an exploratory laparotomy was performed showing her bowel loops were dilated with ileocolic intussusception. The lead point of intussusception (a well-defined 4×4×3.5 cm solid mass), was found at 15 cm proximal to the ileocecal junction. A right hemicolectomy with ileo-transverse anastomosis was performed. The histopathological examination confirmed the presence of IMT. CONCLUSIONS IMT causing ileocolic intussusception with acute intestinal obstruction is an extremely rare presentation of an uncommon entity in adults. High index of suspicion, and appropriate investigations (x-ray abdomen, ultrasound, computed tomography, and colonoscopy) depending on presentation and clinical condition of the patient can result in prompt diagnosis and early management.


Assuntos
Doenças do Íleo/etiologia , Doenças do Íleo/cirurgia , Obstrução Intestinal/etiologia , Intussuscepção/complicações , Intussuscepção/cirurgia , Neoplasias de Tecido Muscular/complicações , Doença Aguda , Adulto , Feminino , Humanos , Obstrução Intestinal/cirurgia , Laparotomia
20.
Ann R Coll Surg Engl ; 102(4): e1-e4, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31928361

RESUMO

While appendiceal intussusception is an uncommon pathological condition, mucinous cystadenoma of the appendix is a particularly rare entity. We report a case of appendiceal intussusception induced by a mucinous cystadenoma presenting as acute appendicitis. A 37-year-old woman was admitted with a one-day history of acute onset, right lower abdominal pain. Computed tomography showed swelling of the appendix, a pathological mass in the ileocolic region and oedematous pericolonic fat stranding. Emergency laparotomy via a McBurney incision revealed that the base of the appendix was swollen and intussuscepting into the caecum. Palpation of the caecum demonstrated an intraluminal mass, 6cm in size, at the appendicocaecal junction. After extension of the McBurney incision, a caecotomy was performed to investigate the mass, following which a cauliflower-like tumour started to protrude. En bloc excision was undertaken of both the appendix and the tumorous mass with a clear surgical margin to send for frozen section analysis. The biopsy samples indicated a mucinous neoplasm. Ileocaecal resection was therefore performed with ileocolic anastomosis. The resected specimen contained a tumour arising from the appendix. The tumour measured 5.3cm x 5cm x 3cm in the caecal cavity and the appendix had invaginated into the caecum at its base. The cut surface of the appendix showed the mucinous tumour projecting into the caecal cavity. Microscopic examination revealed a low grade mucinous cystadenoma.


Assuntos
Neoplasias do Apêndice/diagnóstico , Apendicite/diagnóstico , Colectomia , Cistadenoma Mucinoso/diagnóstico , Intussuscepção/cirurgia , Adulto , Neoplasias do Apêndice/complicações , Neoplasias do Apêndice/cirurgia , Apêndice/diagnóstico por imagem , Apêndice/patologia , Biópsia , Ceco/cirurgia , Cistadenoma Mucinoso/complicações , Cistadenoma Mucinoso/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Íleo/cirurgia , Intussuscepção/etiologia , Tomografia Computadorizada por Raios X
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