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Anand A, Nagpal A, Arsia A, Ahuja A. Rare cause of intussusception in a young male with a new possible etiology - A case report. Int J Surg Case Rep 2023; 106:108204. [PMID: 37119754 PMCID: PMC10173147 DOI: 10.1016/j.ijscr.2023.108204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 05/01/2023] Open
Abstract
INTRODUCTION Inflammatory Fibroid Polyp (IFP) is a rare benign tumor of the gastrointestinal tract with no proven etiology. IFPs may sometimes produce complications like intussusception when present in the small bowel. This is a case report of a patient with an established diagnosis of inflammatory fibroid polyp with abdominal tuberculosis. Such co-existence has not been reported yet in literature. CASE PRESENTATION In this case report we see a 22-year-old gentleman presenting with a 10-day history of generalized abdominal pain which then progressed to obstipation. X-ray abdomen findings were consistent with small bowel obstruction. Computerized tomography imaging revealed the presence of a Jejuno-ileal intussusception. The patient was taken up for emergency laparotomy and he underwent resection of the intussuscepted segment with a polyp found as the lead point accompanied by dense bowel adhesions. Histopathological examination revealed it to be a Benign Fibro epithelial Polyp. Histopathology of the resected bowel segment and mesenteric lymph node also revealed findings confirmatory of abdominal tuberculosis. This may be a possible new etiology of the fibro epithelial polyp and this co-existence has never been reported before in literature. CONCLUSION Tuberculosis may be a possible inciting factor for the development of benign fibro epithelial polyp in the small bowel which may in turn lead to complications such as small bowel intussusception warranting need for surgical intervention.
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Affiliation(s)
- Arti Anand
- Lady Hardinge Medical College, New Delhi 110001, India.
| | | | - Ashish Arsia
- Department of Surgery, Lady Hardinge Medical College, New Delhi 110001, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi 11001, India
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Jacob S, Lee T, Yuen L. Rare case of small bowel intussusception secondary to an Inflammatory Fibroid Polyp (Vanek's tumour). ANZ J Surg 2021; 91:E673-E674. [PMID: 33634595 DOI: 10.1111/ans.16709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Susan Jacob
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Taina Lee
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Lawrence Yuen
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
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Lee SH, Chung JH, Choi CW, Kim SJ, Kim DH, Choi CI, Hwang SH. Potential Therapeutic Approaches for the Intussusception Through a Side-to-Side Jejunojejunal Anastomosis After Laparoscopic Gastrectomy. Surg Laparosc Endosc Percutan Tech 2021; 30:144-150. [PMID: 32150119 DOI: 10.1097/sle.0000000000000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We reviewed our experience with the management of intussusception presenting as a complication of laparoscopic gastrectomy (LG) and studied the feasibility of a laparoscopic intervention to treat or prevent this condition. We retrospectively analyzed the data of 12 patients diagnosed with intussusception, following gastrectomy, from 2008 to 2017, including clinical manifestations, incidence, post-LG time-interval before diagnosis, and treatment. Totally, 12/2300 gastrectomy patients (0.52%) developed intussusception. All 12 had undergone laparoscopic distal gastrectomy for gastric cancer (12/1250, 0.96%) and presented with intussusception through a side-to-side jejunojejunal anastomosis. The mean latency period was 423.8 (range: 86 to 1500) days. Four patients underwent emergent laparoscopic reduction of the efferent loop without bowel resection, along with fixation of the reduced jejunum to the afferent loop and the small bowel mesentery, to prevent a recurrence. One patient required open surgery with manual reduction and segmental resection of the gangrenous small bowel portion. All operated patients recovered without any complications. Intussusception resolved spontaneously in the remaining 7/12 patients. We found that a laparoscopic approach can be used for preventing or managing post-LG intussusception. We found that recurrence can be prevented or treated by anchoring and fixing the (reduced) efferent loop to the afferent loop and the small bowel mesentery.
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Affiliation(s)
- Si-Hak Lee
- Departments of Surgery.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan
| | | | | | | | - Dae-Hwan Kim
- Department of Surgery, School of Medicine, Pusan National University, Busan, South Korea
| | - Chang In Choi
- Department of Surgery, School of Medicine, Pusan National University, Busan, South Korea
| | - Sun-Hwi Hwang
- Departments of Surgery.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan
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Wu HY, Huang SF, Pan KT, Yu MC. Preoperative radiologic patent blue localization for intracorporeal laparoscopic resection of a terminal ileal submucosal lipoma: A case report. Int J Surg Case Rep 2018; 45:91-95. [PMID: 29604532 PMCID: PMC6000738 DOI: 10.1016/j.ijscr.2018.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/20/2018] [Accepted: 03/05/2018] [Indexed: 01/06/2023] Open
Abstract
Small submucosal ileal lesion is difficulty to localize when laparoscopic surgery. Localization by radiologic intervention is effective and harmless. laparoscopic submucosal lipoma resection could be performed intracorporeally.
Background Ileal submucosal lipomas are rare cases and surgical intervention was necessary in case of abdominal pain and intussusception. Laparoscopic resection may be difficult for the intraluminal submucosal lesion. Herein, we report a case of terminal ileal submucosal lipoma resected by radiologic-assisted laparoscopic surgery. Case presentation The 31-year-old female was admitted for intermittent abdominal pain. The colonoscopy showed a 1.5 cm diameter subepithelial lesion in terminal ileum and computed tomography showed a hypodense lesion in distal ileum. The diagnosis of terminal ileal submucosal lipoma without obstruction was impressed and surgical strategy of minimal invasive surgery was taken. Preoperative CT-guided patent blue dye injection near the terminal ileal submucosal lipoma for localization was performed by Radiologist. Then laparoscopic resection with intracorporeal suture was done smoothly without complications. The pathology proved lipoma and she had good recovery within one week. Conclusions There are many kinds of intervention methods to treat the small bowel lipoma. Our experience supports that laparoscopic surgery with radiologic localization assistance is feasible for terminal ileal nonintussusceptive submucosal lipoma resection.
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Affiliation(s)
- Hsin-Yi Wu
- Department of General Surgery, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33305, Taiwan.
| | - Song-Fong Huang
- Department of General Surgery, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33305, Taiwan.
| | - Kuang-Tse Pan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital Linkou Branch, No.5, Fuxing St., Guishan Dist., Taoyuan City 33305, Taiwan.
| | - Ming-Chin Yu
- Department of General Surgery, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33305, Taiwan; Department of Surgery, Xiamen Chang Gung Hospital, Xiamen, Fujian, China.
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Martínez-Ubieto F, Jiménez-Bernadó T, Bueno-Delgado A, Martínez-Ubieto J, Pascual-Bellosta A. Recurrent intestinal intussusception in an adult due to intestinal pseudopolyps not associated with inflammatory bowel disease: a case report. J Med Case Rep 2015; 9:260. [PMID: 26593269 PMCID: PMC4656180 DOI: 10.1186/s13256-015-0754-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 10/27/2015] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Intestinal intussusception is very rare in adults and, unlike in children, it is due to an organic cause, mainly benign or malignant tumors, in 90 % of cases. Recurrent intussusception in an adult is even more exceptional, and in the case reported it was due to repeated occurrence of intestinal pseudopolyps, which is exceptional according to the literature. Preoperative diagnosis is difficult, and surgery is always indicated because a tumor is usually present. The surgical procedure may be controversial, as some would prefer desintussusception before resection, while others would advocate initial resection because of the risk of dissemination if a malignant lesion exists. CASE PRESENTATION We report the case of a 34-year-old Caucasian man who underwent emergency laparoscopic surgery for intestinal obstruction and was found to have a jejunal intussusception. Polyps or pseudopolyps, some of them large and causing the intussusception, were seen in the surgical specimen. Our patient had also undergone surgery for intussusception 10 years before, after which the pathological report also noted the presence of these formations. CONCLUSIONS Recurrent intussusception in adults due to the presence of intestinal pseudopolyps is exceptional and, to the best of our knowledge, this is the first such case reported.
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Affiliation(s)
| | | | - Alvaro Bueno-Delgado
- Digestive and Bariatric Surgery Department, Viamed MontecanalHospital, 50008, Zaragoza, Spain.
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Shimazaki J, Nakachi T, Tabuchi T, Suzuki S, Ubukata H, Tabuchi T. Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report. World J Surg Oncol 2015; 13:75. [PMID: 25890311 PMCID: PMC4340886 DOI: 10.1186/s12957-015-0504-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 02/09/2015] [Indexed: 11/10/2022] Open
Abstract
Adult intussusception is rare and usually caused by a tumor acting as the lead point. Therefore, laparotomy should be considered for the treatment. Laparoscopic procedures for use in cases of adult intussusception have been recently reported; however, there is no consensus regarding the safety and efficacy. Here, we describe a successful case of laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma, which was preoperatively suspected. An 87-year-old male presented with progressive abdominal distention and vomiting. Contrast radiography of the small intestine showed an ileal tumor, and magnetic resonance imaging indicated a target-like mass, consistent with an ileal intussusception. The patient was suspected with an intussusception due to an ileal lipoma, and laparoscopic surgery was performed. An approximately 10-cm-long ileal intussusception with a preceding tumor was present, and partial resection of the ileum, including the tumor, was performed. Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma. The patient had an uneventful recovery and was discharged on postoperative day 8. This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.
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Affiliation(s)
- Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan.
| | - Takeshi Nakachi
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan.
| | - Takanobu Tabuchi
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan.
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan.
| | - Hideyuki Ubukata
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan.
| | - Takafumi Tabuchi
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan.
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