Jejunojejunal intussusception secondary to adenocarcinoma

Colocolic Intussusception in an Adult Patient Secondary to Caecal Adenocarcinoma

Acute intestinal invagination is the pathology of infants and small children. Its occurrence in adults is rare, and it represents 1 to 5% of intestinal occlusions often leading to the discovery of an organic cause that may be tumor. We report the case of a 72-year-old patient admitted to the emergency room of Ibn Sina Rabat, Morocco, for intestinal occlusion. The abdominal CT scan showed a voluminous intestinal invagination on a very probable heterogeneous digestive mass. The treatment was an open right hemicolectomy. The histopathological examination of the surgical specimen concluded a colonic well-differentiated adenocarcinoma with a 30% mucinous component. By review of literature, we discuss diagnostic and therapeutic procedures in emergency.

[Acute intestinal intussusception revealing intestinal T-cell lymphoma in adults]

Acute intestinal intussusception occurs primarily in infants and young children. It uncommonly occurs in adults. It can have various causes. In the vast majority of cases, it is secondary to a benign or malignant tumor. Intestinal T-cell lymphoma revealed by intestinal intussusception is very rare. We report the case of a 43-year old patient admitted with intestinal occlusion to the Emergency Department at the University Hospital Hassan II, Fes, Morocco. Abdominal CT scan showed acute intestinal intussusception associated with incarcerated bowel loop with bowel wall thickening. Treatment was based on open carcinological resection. Anatomopathological and immunohistochemical examination of the surgical specimen showed large T-cell anaplastic lymphoma. After surgery, chemotherapy was indicated to improve prognosis and to avoid a potential relapse. Intestinal intussusception rarely occurs in adults. It most often leads to the detection of an organic cause such as a tumor. This study and literature review aim to highlight the clinical and diagnostic features as well as the therapeutic approaches for this rare disease.

[Colonic lymphoma revealed by ileocecal intussusception in adults: about a case]

L'invagination intestinale est une affection très fréquente en pédiatrie, alors que chez l'adulte, elle reste une entité clinique rare et ne représente que 10% de l'ensemble des invaginations et 4% des occlusions intestinales. Un lymphome colique révélé par invagination intestinale est une entité très rare. Nous rapportons le cas d'une femme de 21 ans, admise aux urgences de l'hôpital Militaire Mouly Ismail à Meknes, Maroc pour une subocclusion intestinale. Le scanner abdominal a montré la présence du boudin d'invagination ainsi que la cause organique au niveau colique. La résection chirurgicale était le traitement choisi, avec un examen anatomopathologique de la pièce opératoire qui montre la présence d'un lymphome B de type diffus à grandes cellules. Après la chirurgie, une chimiothérapie est indiquée dans le but d'améliorer le pronostic et d'éviter une éventuelle rechute.

A Rare Case of Primary Small Bowel Adenocarcinoma with Intussusception

Other than in childhood, intussusception is unusual and nearly always caused by a structural and well demonstrable lesion. In contrast with the colon tract, the incidence of primary malignancies in the small bowel is very low. We report the case of a 51-year-old man presenting with jejunal intussusception due to a primary adenocarcinoma. To our knowledge, only a few similar cases have been reported in the literature to date. The patient was referred to our division for bowel obstruction. A CT scan showed a jejunal intussusception and surgical exploration was hence considered. At laparotomy, jejunal intussusception located just after the ligament of Treitz due to a polypoid lesion was confirmed and resection of the first jejunal loop was carried out. Histological examination of the specimen resulted in a diagnosis of a primary adenocarcinoma of the small bowel. In adult intestinal intussusception, resection without reduction is considered the optimal management if an underlying primary malignancy cannot be excluded.

Adult jejunojejunal intussusception in the face of jejunal adenocarcinoma: two infrequently encountered entities

Adult intussusception and small bowel adenocarcinoma are rarely encountered together. Intussusception should be considered in the differential diagnosis of adult patients presenting with abdominal pain, especially those with unremitting symptoms. Concomitant anaemia should lower the threshold for suspicion of underlying malignancy. Jejunal adenocarcinoma represents a rare, but possible aetiology.

A case of jejunal adenocarcinoma diagnosed by preoperative double balloon enteroscopy

Despite a thorough history, physical examination, and complete diagnostic workup, the correct diagnosis of small-intestinal malignancy is established preoperatively in only 50% of cases; an exploratory laparotomy is often required. However, recent advances in endoscopic technologies, such as double-balloon enteroscopy (DBE), have been shown to facilitate the preoperative diagnosis of these tumors. Confirmation of malignancy using DBE in equivocal cases may greatly increase both patients' acceptance of surgery and the confidence of the physician planning a surgical resection. We describe herein the case of a 53-year-old woman with a stage I jejunal adenocarcinoma that was diagnosed by DBE and treated by laparoscopic jejunectomy. Histopathological examination revealed a stage I jejunal adenocarcinoma (T2N0M0) without muscularis propria invasion, lymphovascular invasion, or lymph-node metastasis.

Case report: Jejuno-jejunal invagination from metastatic renal cell carcinoma

Jejuno-jejunal invagination caused by metastatic renal cell carcinoma is a rare entity in the literature. We report a case of metastatic renal cell carcinoma that led to jejuno-jejunal invagination, which was diagnosed by multidedector CT examination.