&amp;lt;italic&amp;gt;Salmonella enteritis&amp;lt;/italic&amp;gt;: A Rare Cause of Adult Intussusception

Pham, Toàn; Paglia, Domenic La; Pitcher, Meron

doi:10.3393/ac.2017.33.5.201

Cited by 2 publications

(2 citation statements)

References 8 publications

(12 reference statements)

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“…Another finding in our study was that the presence of diarrhea or fever in patients ultimately diagnosed with intussusception may have led to misdiagnosis as acute gastroenteritis. Previous studies have reported that bacterial enteritis significantly increases the relative risk of intussusception ( 29 , 30 ). An increased risk of intussusception was found after Salmonella, E. coli, Shigella , and Campylobacter infection ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound May Reduce Misdiagnosis of Pediatric Intussusception

et al. 2021

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Aim: Intussusception, the most common abdominal emergency in early childhood, is frequently misdiagnosed at initial presentation. The effect of using point-of-care ultrasonography (POCUS) by emergency medicine physicians on pediatric intussusception misdiagnosis rate remains unclear. Here, we summarize outcomes and misdiagnoses before and after training junior and senior physicians on using POCUS for diagnosing intussusception and compared their performance levels.Materials and Methods: This observational cohort analysis included patients with suspected intussusception who visited a pediatric emergency department (ED) between January 2017 and December 2019. All enrolled patients were evaluated by junior (<10-year experience) or senior attending physicians. Misdiagnosis was defined as a finding of negative air reduction or confirmation of diagnosis on ED revisit or admission. The misdiagnosis rates and outcomes before and after POCUS training for intussusception diagnosis were evaluated and performance of the junior and senior physicians was compared.Results: Of the 167 enrolled patients, 130 were confirmed to have intussusception by air reduction. Misdiagnosis rate was significantly lower in the post-training patient group after training than in the pre-training patient group (43.7 vs. 12.7%, P < 0.001). After training, fewer misdiagnoses were made by the junior (59.1 vs. 25.9%, P = 0.003) and senior (31.7 vs. 0%, P < 0.001) physicians. In the post-training patient group, the door-to-reduction time and rate of ultrasonography consultation with an expert also decreased significantly (118.2 ± 124.5 vs. 198 ± 250.2 min, P = 0.006). Abdominal pain (80.9%) was the most common symptom of intussusception, followed by vomiting (58.3%), fever (17.8%), bloody stool (15.4%), and diarrhea (14.2%). Even after training, the presenting symptoms of intussusception often leading junior physicians to misdiagnosis were diarrhea and fever.Conclusions: A brief POCUS training leads to decreased misdiagnosis rates in both the senior and junior physicians. Junior physicians should increase their awareness regarding diarrhea and fever being the presenting symptoms of intussusception, particularly in early childhood. Combining clinical judgment and POCUS results forms the core principle of the evaluation of children with intussusception.

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Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound May Reduce Misdiagnosis of Pediatric Intussusception

et al. 2021

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“…Thus, it is considered to be important to decide the treatment strategy according to the degree of symptoms; in cases with few symptoms, non-invasive reduction, such as endoscopy and barium examination, was a first choice and incases with strong symptoms, surgery was performed with careful consideration for bowel ischemia. Moreover, it is considered necessary to evaluate the mucosal surface for distinguishing the condition from special intussusception, such as parasites [22,23]. We believe that minimal bowel resection or early endoscopic observation after surgery was desirable.…”

Section: Discussionmentioning

confidence: 99%

Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report

et al. 2020

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Background Adult intussusception is recognized as an abdominal emergency. More than 90% of adult patients with intussusception have distinct causes that are related to benign or malignant tumors. In contrast, idiopathic intussusceptions, which are observed in children, are rare conditions in adult. Especially, colo-colonic idiopathic intussusceptions are rare among them. Surgery is traditionally considered the primary treatment option. Recently, laparoscopic surgery has been reported to be safe and feasible. However, laparoscopic surgical reduction, which is a common procedure in pediatric surgery, is not common in adult intussusception. Case presentation We report a 34-year-old man who presented with sudden abdominal pain. Computed tomography revealed the target sign in the transverse colon. There was no evidence of bowel obstruction, bowel wall edema, or tumor. We diagnosed idiopathic intussusception and selected laparoscopic procedure because of the strong abdominal pain experienced by the patient. There were no signs of perforation, bowel wall ischemia, or tumor in abdominal cavity. We confirmed idiopathic colo-colonic anterograde intussusception. Laparoscopic surgical reduction was achieved by a combination of delicate direct pressure on the anal side of the transverse colon and gentle pulling on the oral side. The patient’s postoperative course was uneventful. Conclusions We achieved successful surgical reduction laparoscopically because of an accurate preoperative diagnosis based on characteristic computed tomography features and appropriate surgical technique. Laparoscopic procedure and surgical reduction is considered to be an effective treatment strategy for adult idiopathic intussusceptions with severe symptoms.

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<italic>Salmonella enteritis</italic>: A Rare Cause of Adult Intussusception

Cited by 2 publications

References 8 publications

Point-of-Care Ultrasound May Reduce Misdiagnosis of Pediatric Intussusception

Point-of-Care Ultrasound May Reduce Misdiagnosis of Pediatric Intussusception

Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report

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