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1.
Medicine (Baltimore) ; 99(31): e21525, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756196

RESUMO

RATIONALE: Adult intussusception is rarely observed, accounting for about 5% of all cases of intussusception. Most ileal lipomas are asymptomatic and do not need any special treatment. Herein, we describe a case with ileocolic intussusception caused by ileal lipoma. PATIENT CONCERNS: A 27-year-old woman complaints of intermittent abdominal pain for 10 days. DIAGNOSIS: Abdominal computed tomography demonstrated ileocolic intussusception. Colonoscopy revealed a spherical polypoid lesion with surface capillary rising from the lateral wall of the ileum. A diagnosis of ileocolic intussusception was made. INTERVENTIONS: The patient underwent primary resection of the intussuscepted intestine after which an end-to-end anastomosis was performed. OUTCOMES: Histopathology report confirmed a 4.5 cm × 3.5 cm lipoma in the terminal ileum. The patient was discharged on a postoperative day 9 without complications. LESSONS: We describe the difficulties in diagnosis and treatment of this rare cause of intussusception and review the literature on adult intussusceptions. The ileal lipoma is a very rare cause of ileocolic intussusception. Abdominal CT and colonoscopy are important for the diagnosis of intussusception and abdominal lipomas. Surgical resection remains the treatment of choice.


Assuntos
Doenças do Colo/etiologia , Doenças do Íleo/complicações , Intussuscepção/etiologia , Lipoma/complicações , Adulto , Feminino , Humanos , Doenças do Íleo/cirurgia , Lipoma/cirurgia
2.
Medicine (Baltimore) ; 99(28): e21199, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664167

RESUMO

RATIONALE: Blue rubber bleb nevus syndrome (BRBNS) is an extremely rare disorder characterized by multifocal venous malformations involving various organs such as the skin and gastrointestinal tract. Severe complications of BRBNS, such as intussusception, volvulus, and intestinal infarction are rarer and require surgery. This report describes a 33-year-old male of BRBNS complicated with intussusception that was successfully diagnosed and treated with surgery. PATIENT CONCERNS: A 33-year-old Chinese man presented with persistent, colicky pain accompanied by nausea, abdominal distension, and dizziness. The patient presented with sporadic bluish nodules on his skin involving his head, neck, thorax, abdomen, and planta pedis. DIAGNOSES: BRBNS with the complication of intussusception. INTERVENTIONS: An emergency laparotomy was performed, and postoperative management included blood transfusions and oral iron supplementation for 2 weeks. OUTCOMES: The patient's postoperative course of hospitalization was uneventful. During the 4-month follow-up, the patient showed no signs of intussusception recurrence. LESSONS: Patients diagnosed with BRBNS who present with acute abdominal pain and distension should raise suspicion for the presence of intussusception, which requires emergent surgical intervention.


Assuntos
Neoplasias Gastrointestinais/complicações , Intussuscepção/etiologia , Nevo Azul/complicações , Neoplasias Cutâneas/complicações , Adulto , Humanos , Masculino
3.
Am J Emerg Med ; 38(8): 1697.e1-1697.e3, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32546319

RESUMO

Adult intussusception is an uncommon cause of abdominal pain and poses diagnostic challenges for emergency physicians due to its varied presenting symptoms and time course. We report a case of chronic colocolic intussusception secondary to a lead point submucosal lipoma. Dedifferentiating intussusception with or without a lead point is important in determining appropriate management.


Assuntos
Doenças do Colo/etiologia , Neoplasias do Colo/complicações , Intussuscepção/etiologia , Lipoma/complicações , Dor Abdominal/etiologia , Adulto , Doenças do Colo/diagnóstico , Doenças do Colo/diagnóstico por imagem , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/diagnóstico por imagem , Humanos , Intussuscepção/diagnóstico , Intussuscepção/diagnóstico por imagem , Lipoma/diagnóstico , Lipoma/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X
4.
Gan To Kagaku Ryoho ; 47(4): 649-651, 2020 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-32389972

RESUMO

In September 2015, a 90-year-old woman presented with abdominal pain and emesis as the chief complaints. Except for WBC counts of 10,420/mL, CRP levels of 5.69mg/dL, and ALP levels of 359 IU/L, no other abnormal values were noted, and CEA and CA19-9 tumor marker levels were normal at 3.9 ng/mL and 5.7 U/mL, respectively. Abdominal CT showed intussusception of the right colon and a solid tumor at the presenting portion. Surgery for suspected intussusception caused by colon cancer was performed. Surgical findings revealed a protruding lesion at the ascending colon that extended to the transverse colon, and the intussusception was intrusive up to the ascending colon at the end of the intestinal ileum. Thus, resection of the right half colon and dissection of lymph nodes were performed. Resected specimens revealed a type 1 tumor measuring 65×50×30mm in diameter at the ascending colon. Histopathologic findings revealed tub1>tub2, SS, ly0, v0, PM0, DM0, N0 (0/27)Stage Ⅱa tumor. The postoperative course was favorable, and the patient was discharged on postoperative day 12. We report about a rare case of intussusception caused by ascending colon cancer.


Assuntos
Colo Transverso , Neoplasias do Colo , Intussuscepção , Idoso de 80 Anos ou mais , Colo Ascendente , Neoplasias do Colo/complicações , Feminino , Humanos , Íleo , Intussuscepção/etiologia
5.
Khirurgiia (Mosk) ; (3): 67-73, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32271740

RESUMO

OBJECTIVE: To analyze acute complications of stromal gastrointestinal tumors and determine diagnosis and optimal treatment of these patients. MATERIAL AND METHODS: There were 33 patients with acute complications of GIST aged 40-74 years. RESULTS: Acute complications were presented by gastrointestinal and (or) intratumoral (interstitial) bleeding (n=31). Hemorrhage was combined with stomach perforation in 1 case, intussusception and obstruction of the duodenum in 1 patient, small bowel obstruction in 2 patients. All findings were confirmed by the marker CD 117 (+). One patient died in long-term period after R0-resection and chemotherapy. Targeted therapy was used in 2 patients. CONCLUSION: Clinical examples indicate the progress in diagnosis and treatment of GIST due to development of instrumental imaging techniques, histological and histochemical verification of the process.


Assuntos
Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/terapia , Adulto , Idoso , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Tumores do Estroma Gastrointestinal/diagnóstico , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/terapia , Intestino Delgado , Intussuscepção/etiologia , Intussuscepção/terapia , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas c-kit/análise
6.
Medicine (Baltimore) ; 99(16): e19888, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32312016

RESUMO

RATIONALE: Although percutaneous endoscopic gastrojejunostomy (PEG-J) tubes are believed to reduce the side effect of aspiration, cautious catheter management is required. Intussusception is a serious complication of these tubes. PATIENT CONCERNS: A 7-year-old boy bedridden with hypoxic encephalopathy owing to drowning at the age of 1 year was admitted our hospital with urinary retention for 1 month. At the age of 4 years, a PEG-J tube was inserted. Concomitant with hyperaldosteronemia, an intestinal intussusception from the duodenum to the jejunum was observed via computed tomography (CT). The patient's condition worsened dramatically; gastrointestinal perforation was suspected, and laparotomy was performed. DIAGNOSIS: Jejuno-jejunal intussusception. INTERVENTIONS: Open surgery was performed to release the intussusception. By assessing the reduced intestinal tract, the intussusception starting from a 50 cm portion from the Treitz ligament had been extended to 100 cm from the Treitz ligament. The oral side jejunum was dilated. No evidence of intestinal perforation or strangulated ileus was observed, and the intussusception was manually remediable. OUTCOMES: Preoperative CT examination showed intussusception from the duodenum to the jejunum. Laparotomy showed intussusception on the anal side of the Treitz ligament. With regard to the CT findings associated with the progression of intussusception to the duodenal site, as a result of the telescope phenomenon extending to the duodenum due to the relaxation of the Treitz ligament through repeated intussusception, it was considered that CT examination revealed intussusception extending from the jejunum to the duodenum of oral side. After 3 postoperative weeks, the patient was finally able to return home. LESSONS: If the ileus is observed during the insertion of a PEG-J, clinicians should consider the possibility of intussusception even in the duodenum.


Assuntos
Endoscopia Gastrointestinal/métodos , Derivação Gástrica/efeitos adversos , Intussuscepção/etiologia , Jejunostomia/efeitos adversos , Estômago/cirurgia , Criança , Duodeno/patologia , Duodeno/cirurgia , Derivação Gástrica/instrumentação , Humanos , Doença Iatrogênica , Íleus/diagnóstico , Íleus/etiologia , Intussuscepção/patologia , Doenças do Jejuno/diagnóstico por imagem , Doenças do Jejuno/etiologia , Doenças do Jejuno/patologia , Jejuno/patologia , Jejuno/cirurgia , Laparotomia/métodos , Masculino , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
7.
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
8.
World Neurosurg ; 138: 749-757, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31931245

RESUMO

This paper retrospectively analyzed 28 cases of children diagnosed with repeated intestinal malformations in our hospital from October 2014 to November 2016. The characteristics of ultrasound sonograms of children were evaluated. The images of intestinal repetitive malformations were classified and summarized to identify their common sites, the characteristics of various types of ultrasound sonograms, the main points of ultrasound diagnosis and identification, and the experience of ultrasound workers in daily inspection of children with repetitive malformations of the digestive tract. We analyzed the images of some common complications caused by repeated bowel malformations and identified the main points of ultrasound diagnosis. We then compared the results of ultrasound with other imaging findings, surgery, and pathologic results. At the same time, some special types of repeated bowel malformations were analyzed, discussed, and summarized to improve the understanding of ultrasound examination of gastrointestinal diseases in children, and show the superiority of children's abdominal intestine ultrasound. This study found that the ultrasound diagnosis of children with intestinal repetitive deformities has a high detection rate, clear images, clear anatomic levels, and clear blood flow conditions. Compared with other imaging methods, ultrasound has strong operability, real-time dynamics, strong specificity, and no radiation, and things are not easily misdiagnosed and missed. Therefore, ultrasound can be used as the preferred method for preoperative diagnosis, differential diagnosis, and postoperative follow-up review of repeated intestinal malformations in children.


Assuntos
Colo/diagnóstico por imagem , Anormalidades do Sistema Digestório/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Ultrassonografia/métodos , Criança , Pré-Escolar , Colo/anormalidades , Colo/cirurgia , Anormalidades do Sistema Digestório/complicações , Anormalidades do Sistema Digestório/cirurgia , Sistema Nervoso Entérico , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Lactente , Recém-Nascido , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Intestino Delgado/anormalidades , Intestino Delgado/cirurgia , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Intussuscepção/cirurgia , Masculino , Estudos Retrospectivos , Anormalidade Torcional/diagnóstico por imagem , Anormalidade Torcional/etiologia , Anormalidade Torcional/cirurgia
9.
Am J Case Rep ; 21: e919974, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31937749

RESUMO

BACKGROUND Intussusception in adults (AI) accounts for 1% of all cases of bowel obstruction. While pediatric intussusception is well known and almost always idiopathic, an underlying cause is usually found in adults. Indication for surgical treatment and intussusception reduction before resection remain controversial in AI. Here, we present an uncommon case of an immunocompromised patient who had multiple intussusceptions. CASE REPORT A 59-year-old woman, who had received a kidney-pancreas transplant for type 1 diabetes with end-stage renal failure, was admitted to our Intensive Care Unit for septic shock of suspected pulmonary origin. A thoraco-abdominal CT scan demonstrated signs of bilateral pneumonia and multiple abdominal intussusceptions, for which she underwent surgery. Four intestinal intussusceptions were found. Manual desinvagination was performed without bowel resection. After surgery, the patient presented a new bowel obstruction, requiring a second surgery, showing recurrence of 1 intussusception. Segmental resection was indicated, but not performed because of the septic shock, requiring high-dose noradrenalin. The patient progressed toward multi-organ failure, leading to her death a few days later. An autopsy revealed that multiple adenomas were responsible for the intussusceptions. CONCLUSIONS This case confirms that AI is rarely a spontaneous disease and that the therapeutic strategy should be planned accordingly. There is currently no systematic approach for AI, and guidelines are needed to improve its management.


Assuntos
Adenoma/complicações , Hospedeiro Imunocomprometido , Intussuscepção/etiologia , Intussuscepção/cirurgia , Fatores Etários , Autopsia , Evolução Fatal , Feminino , Humanos , Imunossupressores/uso terapêutico , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos , Pneumonia/imunologia , Choque Séptico/imunologia
10.
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
11.
Medicine (Baltimore) ; 98(50): e18280, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852102

RESUMO

RATIONALE: Small bowel intussusception in adults is rare but is more likely to occur in the presence of a lead point. Surgical intervention is necessary in most cases, even if there is successful nonsurgical reduction of the intussusception. PATIENT CONCERNS: A 54-year-old woman who was transferred to our emergency room with complaints of intermittent cramping pain of 4 days' duration. DIAGNOSIS: Abdominal contrast-enhanced computed tomography revealed a jejuno-jejunal intussusception due to an angiolipomatous polyp. INTERVENTION: A single-incision laparoscopic surgery (SILS) was performed without the need for any additional incisions. OUTCOMES: She was uneventfully discharged on postoperative day 4. LESSONS: The SILS procedure with adequate preoperative diagnosis by CT, with or without US, can offer good clinical outcomes for small bowel intussusception. Even surgeons who have little experience with laparoscopic intestinal anastomosis can consider SILS to treat small bowel intussusception in adults.


Assuntos
Pólipos Intestinais/complicações , Intussuscepção/cirurgia , Doenças do Jejuno/cirurgia , Jejuno/cirurgia , Laparoscopia/métodos , Feminino , Humanos , Pólipos Intestinais/diagnóstico , Pólipos Intestinais/cirurgia , Intussuscepção/diagnóstico , Intussuscepção/etiologia , Doenças do Jejuno/diagnóstico , Doenças do Jejuno/etiologia , Jejuno/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
12.
Medicine (Baltimore) ; 98(51): e18294, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860977

RESUMO

RATIONALE: Intussusception, a common cause of intestinal obstruction in children, typically requires medical reduction. Here, we describe the case of a pair of twins who had simultaneous intussusception and were positive for fecal adenovirus-strongly indicating that adenovirus infection may be a main cause of the intussusception. PATIENT CONCERNS: Two 1-year-old twin girls were brought to Cathay General Hospital one after another on the same day. Both presented with intermittent abdominal pain, abdominal distension, diarrhea, and loss of appetite. DIAGNOSES: Their laboratory data were adenovirus positivity in rectal swab culture. Intussusception was diagnosed through a lower gastrointestinal series. INTERVENTIONS: The twins were treated with reduction for intussusception. OUTCOMES: Both patients recovered well, without recurrence. LESSONS: Most cases of intussusception are idiopathic. However, some potential risk factors-as strongly suggested by the current cases-are genetic factors and adenovirus infection.


Assuntos
Infecções por Adenovirus Humanos/complicações , Doenças em Gêmeos/virologia , Doenças do Íleo/etiologia , Intussuscepção/etiologia , Feminino , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/virologia , Lactente , Intussuscepção/diagnóstico por imagem , Intussuscepção/virologia , Radiografia Abdominal , Gêmeos Monozigóticos
13.
Rev. argent. coloproctología ; 30(4): 114-118, dic. 2019. ilus, graf
Artigo em Espanhol | LILACS | ID: biblio-1096800

RESUMO

Los lipomas del colon ocupan el tercer lugar en frecuencia de aparición de tumores benignos. Estos tumores están formados por tejido adiposo bien diferenciado con un estroma fibroso. La gran mayoría de estos lipomas es asintomática, algunos en raras ocasiones presentan complicaciones de urgencia. El fin de esta publicación es presentar un caso de obstrucción de colon por lipoma. (AU)


Benign colonic lesions are infrequent and account for a low percentage of all colonic tumors. Among the benign tumors, lipomas are third in frequency. They are composed of mature adipose tissue with fibrous stroma. Most of them are asymptomatic but in rare instances, they may present as surgical emergencies. We present one case of colonic obstruction caused by lipomas. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias do Colo/complicações , Intussuscepção/etiologia , Intussuscepção/diagnóstico por imagem , Lipoma/complicações , Endoscopia Gastrointestinal/métodos , Colonoscopia/métodos , Laparoscopia/métodos , Neoplasias do Colo/cirurgia , Intussuscepção/cirurgia , Lipoma/cirurgia
14.
PLoS One ; 14(12): e0219286, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31860649

RESUMO

Intussusception is one of the most common causes of intestinal obstruction in young children. We report a retrospective, observational study of the epidemiology of intussusception in South Korea using the National Health Insurance Service-National Sample Cohort (NHIS-NSC). A cohort of newborns born between 2002 and 2008 was selected. The primary objective was to assess the incidence of intussusception in the pediatric population of Korea. The secondary objectives were to describe the basic epidemiological characteristics of intussusception and to identify risk factors. A total of 362 children were identified. The highest incidence of intussusception (2.6 per 1,000) was observed in children aged 1-2 years. A total of 58.8% of the children were male, and there was no significant difference in incidence according to the birth year (P = 0.804). Most of the children diagnosed with intussusception underwent air reduction, while only 0.6% had surgery. In all, 82.3% of the children were admitted to the hospital, 0.8% of them had to be admitted to the ICU, and the 6-month mortality was only 0.3%. In this retrospective, observational study, the incidence of intussusception was highest among children between 1 and 2 years of age. Most of the children underwent air reduction.


Assuntos
Intussuscepção/epidemiologia , Pré-Escolar , Feminino , Hospitalização , Humanos , Incidência , Lactente , Recém-Nascido , Obstrução Intestinal/complicações , Intussuscepção/etiologia , Masculino , Programas Nacionais de Saúde , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estações do Ano , Fatores Sexuais
15.
BMJ Case Rep ; 12(11)2019 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-31776155

RESUMO

We present a case of an unusually large, circumferential tubulovillous adenoma involving the terminal ileum and the caecum with ileocaecal valve consumption, presenting as intussusception in an otherwise healthy 90-year-old woman. The patient presented with several months of chronic symptoms of weight loss and diarrhoea. Clinical examination revealed a right-sided mass. Investigations revealed a large right-sided lesion suspicious of intussusception. The patient underwent a right-sided hemicolectomy where the intussusception was resected. Histology of the resected mass revealed a tubulovillous adenoma with focal invasive adenocarcinoma.


Assuntos
Adenoma/complicações , Neoplasias do Ceco/complicações , Valva Ileocecal , Intussuscepção/etiologia , Adenoma/patologia , Idoso de 80 Anos ou mais , Neoplasias do Ceco/patologia , Feminino , Humanos , Carga Tumoral
16.
Pan Afr Med J ; 33: 214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692747

RESUMO

Primary melanoma of the small bowel is a rare clinical entity with a paucity of published reports in literature. Most cases of gastrointestinal melanomas are metastatic lesions arising from skin or ocular origins. This is a case report of a 63 year old female with adult intussusception with jejunal melanoma as the lead point. The index patient had a long history of abdominal pain associated with significant weight loss and presented with features of intestinal obstruction. The possibility of a regressed or unidentified extra-intestinal site cannot be absolutely excluded as the patient did not have a PET scan. Due to the vague nature of clinical symptoms and signs, the diagnosis of small bowel melanoma is difficult, especially in patients with no obvious cutaneous pathology. A high index of suspicion for melanoma as a malignant lead point for adult intussusception should always be entertained.


Assuntos
Intussuscepção/etiologia , Neoplasias do Jejuno/diagnóstico , Melanoma/diagnóstico , Dor Abdominal/etiologia , Feminino , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Intussuscepção/diagnóstico , Neoplasias do Jejuno/complicações , Melanoma/complicações , Pessoa de Meia-Idade
17.
BMC Surg ; 19(1): 169, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718616

RESUMO

BACKGROUND: Duodenal fibrolipoma and duodenum-jejunum intussusception are both rare occasions in clinical practice. The diagnosis of duodenal fibrolipoma mainly depends on endoscopy examination, supplemented by CT and MRI. As the tumor grows, some severe symptoms need surgical intervention. As the development of endoscopic techniques, the operation plan should be made individually. CASE PRESENTATION: A 47-year-old female with the complaint of upper abdominal pain and melena was reported. Abdominal examination revealed upper abdomen lightly tender and blood test showed severe anemia. Image and endoscopy examination exhibited "a giant mass" in the descending (D2) part of duodenum, dragged by the tumor into the distal intestinal canal and causing intussusception. Intermittent blood transfusion treatment, enteral and parenteral nutrition were adopted to adjust her general state. Two weeks later, the mass was resected together with the basement intestinal wall via the jejunum incision and then the intussuscepted D2 part was restored. The paraffin pathological diagnosis correlated with the preoperative judgment of fibrolipoma and the patient was discharged healthy on POD 14. CONCLUSIONS: Duodenal fibrolipoma is a rare disease, infrequently causing intussusception and severe upper GIB. Duodenoscopy and endoscopic ultrasound contribute to making an appropriate diagnosis, and for patients with severe symptoms needed surgical intervention, operation plan should be individualized depending on the size and location of the lesion.


Assuntos
Duodenopatias/diagnóstico , Neoplasias Duodenais/complicações , Hemorragia Gastrointestinal/diagnóstico , Intussuscepção/diagnóstico , Doenças do Jejuno/diagnóstico , Lipoma/complicações , Duodenopatias/etiologia , Duodenopatias/cirurgia , Neoplasias Duodenais/diagnóstico , Neoplasias Duodenais/cirurgia , Duodenoscopia/métodos , Endossonografia , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Intussuscepção/etiologia , Intussuscepção/cirurgia , Doenças do Jejuno/etiologia , Doenças do Jejuno/cirurgia , Laparoscopia , Lipoma/diagnóstico , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
18.
Medicine (Baltimore) ; 98(44): e17783, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689848

RESUMO

RATIONALE: Postoperative intussusception in adults is a rare but serious complication after gastrointestinal anastomosis surgery. Postoperative intussusception in adults caused by tube feeding was rarely been reported before. The aim of the current study was to summarize the clinical data on a group of patients with tube feeding associated postoperative intussusceptions. The possible etiology and preventive measures will also be discussed. PATIENT CONCERNS: During the period from May 2013 to January 2018, patients who received gastrointestinal anastomosis in our center were retrospectively reviewed. Preoperative variables including standard demographic and pathological characteristics as well as the treatment and prognosis were also analyzed. DIAGNOSES: Tube feeding associated postoperative intussusceptions. INTERVENTIONS: 7 patients were identified with tube feeding associated postoperative intussusceptions with a prevalence of 0.38%. Intussusceptions occurred from 10 to 69 days (median 25.7 days) postoperatively in an acute form. OUTCOMES: None of the patients had spontaneous reduction and all patients underwent surgery. Antegrade efferent limb intussusceptions were found in all the cases. Intussusception occurred at efferent loop at 23.6 cm (range 15-60) from the gastrointestinal or Braun anastomosis. None of the patients was found recurrence throughout the follow-up period. LESSONS: In contrast with other postoperative intussusceptions, the tube feeding associated postoperative intussusceptions have special clinical manifestations. It is more likely to occur in early period of time after the surgery and in an acute form. Surgical correction is recommended for most of patients. Several measures have been proposed to prevent such complications after gastrointestinal surgery, however more research and information are still needed.


Assuntos
Anastomose Cirúrgica/efeitos adversos , Nutrição Enteral/efeitos adversos , Enteropatias/epidemiologia , Intussuscepção/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Feminino , Humanos , Enteropatias/etiologia , Intussuscepção/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Prevalência , Estudos Retrospectivos
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