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Fontana F, Piacentino F, Ossola C, Pascarella RD, Franchi C, Curti M, Coppola A, Basile A, Saverio SD, Carcano G, Venturini M. Gangliocytic paraganglioma leading to duodeno-jejunal intussusception: A case report. Radiol Case Rep 2021; 16:3977-3981. [PMID: 34729128 PMCID: PMC8545659 DOI: 10.1016/j.radcr.2021.09.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 02/07/2023] Open
Abstract
The intussusception of the small bowel is rarely encountered in adult patients and is frequently associated with a lead point that is often malignant. In a 69-year-old female patient with an episode of gastrointestinal (GI) bleeding, computed tomography (CT) showed a duodenal-jejunal intussusception caused by an intraluminal mass. Open polypectomy and reduction of intussusception were performed and the diagnosis of gangliocytic paraganglioma was made at pathological evaluation. It would be important to consider neoplasms like gangliocytic paraganglioma in the setting of adult small bowel intussusception.
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Affiliation(s)
- Federico Fontana
- Diagnostic and Interventional Radiology Department, Ospedale di Circolo, ASST dei Sette Laghi, Varese 21100, Italy
- School of Medicine and Surgery, Università degli Studi dell'Insubria, Varese 21100, Italy
| | - Filippo Piacentino
- Diagnostic and Interventional Radiology Department, Ospedale di Circolo, ASST dei Sette Laghi, Varese 21100, Italy
| | - Christian Ossola
- School of Medicine and Surgery, Università degli Studi dell'Insubria, Varese 21100, Italy
| | | | - Caterina Franchi
- School of Medicine and Surgery, Università degli Studi dell'Insubria, Varese 21100, Italy
| | - Marco Curti
- School of Medicine and Surgery, Università degli Studi dell'Insubria, Varese 21100, Italy
| | - Andrea Coppola
- Diagnostic and Interventional Radiology Department, Ospedale di Circolo, ASST dei Sette Laghi, Varese 21100, Italy
| | - Antonio Basile
- Department of Medical and Surgical Sciences and Advanced Technologies, Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Catania 95123, Italy
| | - Salomone Di Saverio
- School of Medicine and Surgery, Università degli Studi dell'Insubria, Varese 21100, Italy
- Department of General Surgery, ASUR Marche, AV5, Hospital of San Benedetto del Tronto, San Benedetto del Tronto 63074, Italy
| | - Giulio Carcano
- School of Medicine and Surgery, Università degli Studi dell'Insubria, Varese 21100, Italy
- Surgery Department, Ospedale di Circolo, ASST dei Sette Laghi, Varese 21100, Italy
| | - Massimo Venturini
- Diagnostic and Interventional Radiology Department, Ospedale di Circolo, ASST dei Sette Laghi, Varese 21100, Italy
- School of Medicine and Surgery, Università degli Studi dell'Insubria, Varese 21100, Italy
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A. N. Alzerwi N. Duodenoduodenal and duodenojejunal intussusceptions in adults: A systematic review with a focus on demographics, diagnosis, and etiology. AIMS MEDICAL SCIENCE 2020. [DOI: 10.3934/medsci.2020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Zhao B, Zhou X, Wang W. Duodenal descending part-jejunum intussusception and upper gastrointestinal bleeding caused by duodenal fibrolipoma: a case report. BMC Surg 2019; 19:169. [PMID: 31718616 PMCID: PMC6852972 DOI: 10.1186/s12893-019-0634-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/28/2019] [Indexed: 01/12/2023] Open
Abstract
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.
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Affiliation(s)
- Bangbo Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Xingtong Zhou
- Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Weibin Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
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