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Rathod R, Sundaram S, Jain AK, Mane K, Patil P, Mehta S. Endoscopic management of colocolic intussusception in an adult with colonic stent placement. Endoscopy 2022; 54:E464-E465. [PMID: 34571562 DOI: 10.1055/a-1625-5105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Raosaheb Rathod
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
| | - Sridhar Sundaram
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
| | - Aadish Kumar Jain
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
| | - Kiran Mane
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
| | - Prachi Patil
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
| | - Shaesta Mehta
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
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Busa V, Bandaru SS, Mahat R, Janga C. A Rare Case of Colo-Colonic Intussusception Caused by Colonic Submucosal Lipoma. Cureus 2022; 14:e23600. [PMID: 35371854 PMCID: PMC8973248 DOI: 10.7759/cureus.23600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
Unlike in infancy, where intussusception is an abdominal emergency, diagnosis of intussusception could be tricky in adults as most of these patients present sub-acutely with vague abdominal symptoms. Early diagnosis could impact these patients significantly in decreasing morbidity and mortality along with reduction in healthcare expenses. Colo-colonic intussusception is rare and accounts for less than 20% of adult intussusception. More than 50% of adult intussusception is caused by mass-like lesions. In such cases, this could be an early presentation of malignant intestinal lesions. Abdominal CT is mandatory in all adult patients; when combined with ultrasound, it has 95.5% accuracy of pre-operative diagnosis. Here we report a case of a 42-year-old female who presented with a two-month history of intermittent abdominal pain; a CT abdomen revealed colo-colonic intussusception which was initially missed on prior imaging. We discuss the importance of considering intussusception as a rare differential of abdominal pain, the need for early diagnosis, and the role of colonoscopy and non-surgical management in adults.
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Allawati M, Logman T, Al Qubtan MT. Colonic Lipoma as a Leading Cause of Intussusception Resulting in Bowel Obstruction. Cureus 2021; 13:e18261. [PMID: 34712536 PMCID: PMC8542912 DOI: 10.7759/cureus.18261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/18/2022] Open
Abstract
A colon lipoma is defined as a benign tumor made of adipose tissue present in the submucosa. Lipomas of the colon are unusual with a frequency of 0.035%-4.4%. We present an uncommon case of a 41-year-old female with left colonic lipoma causing intussusception. The patient presented with abdominal pain at the left iliac fossa. She underwent an emergency exploratory laparotomy plus left hemicolectomy and was followed in the surgical out-patient clinic postoperatively. She was found doing well taking a normal diet and having normal bowel habits. The overall prognosis depends on the complete removal of the tumor.
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Affiliation(s)
- Meetham Allawati
- Medicine and Health Sciences, Sultan Qaboos University, Muscat, OMN
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Mchirgui E, Elloumi H, Ganzoui I, Triki W. Case Report: A giant fecaloma revealed by severe aspiration pneumonia and urinary retention. F1000Res 2021; 10:691. [PMID: 38707747 PMCID: PMC11069041 DOI: 10.12688/f1000research.54855.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 05/07/2024] Open
Abstract
Fecaloma is an accumulation of hardened impacted stool typically occurring in the sigmoid colon and rectum. It mainly affects elderly and bedridden patients suffering from chronic constipation and can be revealed by different signs. We report a case of 74-year-old female, with anorexia, Alzheimer's disease, and chronic constipation, who was admitted to the emergency department with complaints of dyspnea and anuria. Clinical examination showed fever, Glasgow Coma Scale score of 13/15, tachycardia with a blood pressure of 100/50 mmHg, polypnea with hypoxia, foci of crepitant rales in pulmonary auscultation and a tender hypogastric mass with mild diffuse abdominal tenderness. Digital rectal examination revealed hard fecal material. Computed tomography (CT) images demonstrated bilateral pulmonary parenchymal condensation and a huge heterogeneous fecaloma in the sigmoid colon and rectum compressing the bladder. Based on these findings, the diagnosis of giant fecaloma causing aspiration pneumonia and urinary retention was retained. Manual disimpaction and bowel enemas were done but they were unsuccessful and surgical treatment was refused. Ultimately the patient died due to septic shock. Early diagnosis should be made to relieve symptoms and prevent complications.
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Affiliation(s)
- Elhem Mchirgui
- Emergency Department, Habib Bougatfa hospital, Bizerte, TUNISIA, 7000, Tunisia
| | - Hanen Elloumi
- Gastroenterology Department, Habib Bougatfa Hospital, BIZERTE, TUNISIA, 7000, Tunisia
| | - Imen Ganzoui
- Radiology Department, Habib Bougatfa Hospital, BIZERTE, TUNISIA, 7000, Tunisia
| | - Wissem Triki
- Digestive Surgery Department, Habib Bougatfa Hospital, BIZERTE, Tunisia, 7000, Tunisia
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Kansoun A, Mohtar IA, Bahmad M, Houcheimi F, Maanieh N, Hazim M, Rahal K, Amiry AR, Hoteit A, Saeed AA, Fakhruddin N, Wehbe M. Colo-colic intussusception secondary to colon lipoma: A case report. Int J Surg Case Rep 2021; 81:105695. [PMID: 33721822 PMCID: PMC7970352 DOI: 10.1016/j.ijscr.2021.105695] [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: 01/03/2021] [Revised: 02/14/2021] [Accepted: 02/14/2021] [Indexed: 11/25/2022] Open
Abstract
Intestinal intussusception is rare in adults and it is associated with lead points. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Colo-colic intussusception caused by lipoma must be considered in the differential when diagnosing adults with right lower quadrant pain.
Introduction and importance Intestinal intussusception is rare in adults and it is associated with lead points affecting the colon in around 17% of patients. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Indeed, the incidence of intestinal intussusception is much rare when caused by lipomas. Case presentation Our patient is a 29-year-old male, previously healthy and admitted for severe right lower quadrant abdominal pain of 2-day duration. Computed tomography (CT) scan of the abdomen and pelvis showed large mass of fat consistency containing colon structure. Clinical Discussion Urgent laparotomy was opted during which colo-colic intussusception was diagnosed and right hemicolectomy with primary ileocolic anastomosis was performed. Pathology report showed that intussusception was induced by a colon lipoma. Patient had an uneventful hospital stay and was discharged on post-operative day 5. Conclusion Thus we recommend that colo-colic intussusception caused by lipoma be considered in the differential when diagnosing adults with right lower quadrant pain.
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Affiliation(s)
- Alaa Kansoun
- Lebanese University, Faculty of Medical Sciences, Department of General Surgery, Beirut, Lebanon.
| | - Iyad Al Mohtar
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | - Marwan Bahmad
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | | | - Nisreen Maanieh
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | - Mouhamad Hazim
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | - Khaled Rahal
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | | | - Ali Hoteit
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
| | | | - Najla Fakhruddin
- Department of Pathology, Hammoud Hospital University Medical Center, Saida, Lebanon.
| | - Mohammad Wehbe
- Department of General Surgery, Hammoud Hospital University Medical Center, Saida, Lebanon.
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Sharma A, Thakur A. Ileocolic intussusception due to intestinal lipoma in an adult patient. Clin Case Rep 2021; 9:1524-1528. [PMID: 33768881 PMCID: PMC7981757 DOI: 10.1002/ccr3.3825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 01/01/2023] Open
Abstract
Intestinal obstruction due to intussusception caused by intestinal lipomas is a rare condition in adults that needs urgent treatment. CT (Computerised Tomography) is the radiologic modality of choice for diagnosis. Surgery is the treatment of choice and has excellent outcome.
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Jang HY, Lee JY, Kim SH, Pak MG, Lee JH. [Distal Ileal Lymphoma Presenting Ileocecal Intussusception with Spontaneous Reduction]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2019; 74:291-294. [PMID: 31765557 DOI: 10.4166/kjg.2019.74.5.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/04/2019] [Accepted: 09/08/2019] [Indexed: 11/03/2022]
Abstract
Intussusception is a rare disease in adults. A demonstrable etiology is found in approximately 85% of all cases, and approximately 40% of them are caused by malignant tumors. A 65-year-old patient visited the outpatient department with mild abdominal pain without other symptoms. The initial laboratory test and simple X-ray showed normal findings. CT revealed intussusception in the ileocecal area. The initial colonoscopic biopsy revealed atypical cells. Follow up colonoscopy showed spontaneous reduction of the intussusception. Diffuse large B-cell lymphoma was suspected in the second colonoscopic biopsy. An elective operation was performed. This case reports a case of a spontaneous reduction of adult intussusception with a brief review of literature.
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Affiliation(s)
- Hye Yoon Jang
- Division of Gastroenterology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Jong Yoon Lee
- Division of Gastroenterology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Suk Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Min Gyoung Pak
- Department of Pathology, Dong-A University Hospital, Busan, Korea
| | - Jong Hoon Lee
- Division of Gastroenterology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
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Hamilton AE, Singh A, Austin KK, Shin J, Hong JS. A Rare Pathological Couplet of Colocolic Intussusception Plus Cecal Bascule in a Young Adult: A Case Report. Cureus 2018; 10:e3430. [PMID: 30546977 PMCID: PMC6289586 DOI: 10.7759/cureus.3430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This report is of a rare case involving a 27-year-old female who presented to the hospital with the pathological couplet of colocolic intussusception and cecal bascule causing bowel obstruction. Up to the time of presentation to the hospital, this patient had not undergone a full investigation for a known iron deficiency, anemia. Subsequently, during the emergency admission and after having an operative surgical procedure, the patient was found to have both a congenitally malpositioned cecum and a benign colonic polyp-forming condition. The pertinent issues about this unusual case to be highlighted are its ambiguous clinical presentation; uncommon gender and age group for either condition; the simultaneous occurrence of dual anatomical anomalies; and the uncommon benign etiology of causes of bowel obstruction in adults.
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Affiliation(s)
| | - Angad Singh
- Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, AUS
| | - Kirk K Austin
- Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, AUS
| | - JooShik Shin
- Pathology, Royal Prince Alfred Hospital, Sydney, AUS
| | - Jonathan S Hong
- Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, AUS
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M'rabet S, Jarrar MS, Akkari I, Abdelkader AB, Sriha B, Hamila F, Letaief R, Jazia EB. Colonic intussusception caused by a sigmoidal lipoma: A case report. Int J Surg Case Rep 2018; 50:1-4. [PMID: 30059860 PMCID: PMC6079477 DOI: 10.1016/j.ijscr.2018.06.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/20/2018] [Indexed: 12/14/2022] Open
Abstract
Intestinal intussusception in adults is rare, accounting for approximately 1% of all bowel obstructions. Colo-colonic intussusception accounts for 17% of cases. The occurrence of large lipomatous masses as cause of intussusception and semi-obstructive symptoms remains rare. The case that we describe is particularly unique because apart from being an example of intussusception in adults, it occurred in the sigmoid colon and was not associated with a malignant lesion.
Introduction Intussusception is a relatively common condition seen in children. In comparison, adult intussusception is rare and is often secondary to inflammatory diseases, benign or malignant tumors and motility disorders. Being a benign cause, lipomas appear as a particularly rare gastrointestinal tumor. Presentation of Case We present a case of colo-colonic intussusception secondary to a sigmoidal lipoma, in a 40-year-old man. We describe the different aspects of diagnosis and management of this rare complication. Discussion Adult intussusception is the cause of symptomatic bowel obstruction in 1% of cases and its colo-colonic occurrence represents 17% of all intestinal intussusceptions. The case that we describe is particularly unique because apart from being an example of intussusception in adults, it occurred in the sigmoid colon and was not associated with a malignant lesion. The treatment of intussusception in adults is surgical resection because of the high incidence of underlying malignancy. Colonoscopy is a modality which allows direct visualization of the lipoma. However, intraluminal reduction via colonoscopy is not recommended. Conclusion Colo-colonic intussusception is a very rare complication of lipoma. It is determined that the treatment is surgical due to the risk of malignancy.
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Affiliation(s)
- Soumaya M'rabet
- Department of Gastroenterology, Farhat Hached University Hospital, Sousse, Tunisia.
| | | | - Imen Akkari
- Department of Gastroenterology, Farhat Hached University Hospital, Sousse, Tunisia
| | | | - Badreddine Sriha
- Department of Anatomical Pathology University Hospital, Sousse, Tunisia
| | - Fahmi Hamila
- Department of Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Rached Letaief
- Department of Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Elhem Ben Jazia
- Department of Gastroenterology, Farhat Hached University Hospital, Sousse, Tunisia
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Sunkara T, Caughey ME, Culliford A, Gaduputi V. A Rare Case of Adult Colonic Intussusception from Benign Etiology. Cureus 2018. [PMID: 29531876 PMCID: PMC5837297 DOI: 10.7759/cureus.2023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Defined as the tunneling of one bowel segment into an adjacent bowel segment, intussusception is typically observed in pediatric populations. Here, we present the case of a 78-year-old man who, in a series of unlikely events, developed colonic intussusception due to a benign lead point pathology. Intussusception of the colon is an uncommon occurrence in adults. However, adult colonic intussusception, observed in the absence of a malignant lead point pathology, represents a true clinical anomaly.
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Affiliation(s)
- Tagore Sunkara
- Internal Medicine/gastroenterology, The Brooklyn Hospital Center, Affiliate of the Mount Sinai Hospital. 121 Dekalb Avenue, Brooklyn, Ny 11201
| | - Megan E Caughey
- Internal Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, Ny
| | - Andrea Culliford
- Department of Internal Medicine, SBH Health System, 4422 Third Ave, Bronx, Ny 10457
| | - Vinaya Gaduputi
- Department of Internal Medicine, SBH Health System, 4422 Third Ave, Bronx, Ny 10457
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