Adult intussusception: a challenge to laparoscopic surgery?

Sun, Mingze; Li, Zhongmin; Shu, Zhenbo; Wu, Qi; Liu, Xue

doi:10.7717/peerj.14495

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…Sun et al recruited 51 adults with intussusception, the mean age was 54 years, and 42 patients were diagnosed by abdominal ultrasound and abdominal CT scan. 15 Among them, 76% had abdominal pain, 12% had blood in the stool, and 6% had a palpable abdominal mass. Of these, 63% had malignant tumors 39% and benign 23%.…”

Section: Discussionmentioning

confidence: 99%

Colocolonic intussusception in an adult secondary to an inflammatory polyp of the transverse colon - clinical case

et al. 2023

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There are multiple causes of colocolonic intussusception in adults, such as tumors, autoimmune pathologies, previous abdominal surgeries, and gynecological conditions. Associated complications are small bowel obstruction, ischemia, necrosis, perforation with peritonitis, and sepsis that require urgent attention. A 78-year-old woman who started with colic in the mesogastrium of 5 months of evolution and changes in bowel habits. She went to the emergency room due to intense pain in the mesogastrium. On physical examination, she presented dehydration of the mucous membranes and pale integuments, pain on superficial and deep palpation in the mesogastrium. Admission laboratories: leukocytosis 17,110/ul, neutrophilia 67.9%, hydroelectrolyte imbalance: mild hyponatremia, mild hypochloremia, slightly prolonged coagulation times, normal blood chemistry. Abdominal ultrasound with "pseudokidney" image. Computed tomography reports an image of the introduction of a segment of the transverse colon into a contiguous segment of the same, with data of associated intestinal pneumatosis. Due to the previous findings, an emergency exploratory laparotomy was performed. Invagination of the transverse colon is located, accompanied by dilation of the vessels of the greater omentum; it is reduced manually, an enterotomy is performed and a tumor dependent on the wall is located, for which a 25 cm transverse colon resection, end colostomy and mucous fistula are decided. Pathology report reports inflammatory polyp. In the postoperative period, the patient improved and was discharged. Abdominal pain is the common presentation of intussusception; however, given its rarity in adults, the possibility of missing the finding on abdominal imaging leads to misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Colocolonic intussusception in an adult secondary to an inflammatory polyp of the transverse colon - clinical case

et al. 2023

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“…Various studies list nonspecific abdominal pain as the most frequently cited symptom, with prevalence ranging from 76.5% to 93.8% in the studied populations [ 6 , 7 ]. As abdominal pain alone is not diagnostic of intussusception, individuals presenting to the emergency department with this finding should undergo imaging to reach the correct diagnosis.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Presentation of Adult Intussusception

Weiss,

Snell,

Knopp

et al. 2024

Cureus

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Intussusception is a condition characterized by the invagination of a proximal segment of the intestine into a distal segment. In adults, intussusception is commonly associated with a lead point. The most alarming lead point is an obstructing malignancy. Here, we present the case of a 57-year-old woman with ileocolic intussusception secondary to colonic adenocarcinoma. The patient presented to the emergency department following an incidental finding of bradycardia, with a heart rate of around 40 beats per minute. She presented with several weeks of cramping, right lower quadrant abdominal pain, lightheadedness, fatigue, and palpitations. A computed tomography scan revealed ileocolic intussusception. After the placement of a semi-permanent right subclavian pacer, the patient underwent a right hemicolectomy. Surgical findings were consistent with ileocolic intussusception suspicious of being initiated by a mass in the right cecum involving the appendiceal orifice and ileocecal valve that invaded through the muscularis propria into subserosal tissue. The mass was resected and sent to pathology, where it was classified as stage II colonic adenocarcinoma. This case highlights a nonspecific presentation of intussusception that was only identified due to incidental bradycardia.

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“…11 Surgical management can safely be undertaken laparoscopically as has been demonstrated previously and in this case. [14][15][16] Higher rates of CT use in adults non-specific abdominal symptoms has led to increased detection of incidental and transient intussusception. are not related to pathologic lead points and are a result of transient peristaltic aberrations.…”

Section: Discussionmentioning

confidence: 99%

Colo-colic intussusception in an adult: case report and review of the literature

Skalkos,

Shamavonian,

Das

et al. 2024

Int Surg J

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Intussusception is rare in adults and is clinically distinct to its occurrence in the paediatric population. Appreciation of these differences by general surgeons is important in guiding management in the adult population. We report the case of a 37 year old presenting with abdominal pain and per rectal bleeding who was found to have transverse colonic intussusception on computed tomography (CT). Colonoscopy and biopsy confirmed a transverse colon adenocarcinoma for which he underwent laparoscopic extended right hemicolectomy. The existing literature around adult intussusception was reviewed. Intussusception presents non-specifically and often subacutely in adults, frequently being overlooked as a diagnosis in this population. Increased use of imaging, in particular CT, have improved preoperative diagnosis. Compared to the paediatric population where intussusception is overwhelmingly idiopathic, in adults it is often due to a pathological lead point, with a significant risk of underlying malignancy. Consequently, surgery without reduction is the mainstay of management in the adult population, in comparison to hydrostatic or pneumatic reduction in the paediatric population. Intussusception is a rare presentation in the adult population. It is commonly caused by a pathologic lead point and should raise suspicion of malignancy particularly when involving the colon. As a result, within the adult population, surgery is the mainstay of management, which can safely be performed laparoscopically.

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Adult intussusception: a challenge to laparoscopic surgery?

Cited by 9 publications

References 33 publications

Colocolonic intussusception in an adult secondary to an inflammatory polyp of the transverse colon - clinical case

Colocolonic intussusception in an adult secondary to an inflammatory polyp of the transverse colon - clinical case

An Unusual Presentation of Adult Intussusception

Colo-colic intussusception in an adult: case report and review of the literature

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