scholarly journals Small bowel intussusception in marijuana users

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Daniel Kakish ◽  
Marwan Alaoudi ◽  
Brian Welch ◽  
David Fan ◽  
Melissa Meghpara ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Acute Abdomen ◽  
Bowel Obstruction ◽  
Adult Intussusception ◽  
Lead Point ◽  
Review Of The Literature ◽  
Pathologic Process ◽  
Small Bowel Intussusception ◽  
Intestinal Obstructions

Abstract Intussusception occurs when one portion of bowel ‘telescopes’ into another due to a lead point created by a range of benign or pathologic process. Intussusception mostly occurs in children. Although adult intussusception (AI) is rare, accounting for <5% of intestinal obstructions, it is more concerning in adults as malignancy accounts for nearly 65% of lead points in AI. Patients present with severe abdominal pain concerning for an acute abdomen along with a degree of bowel obstruction. We have experienced a total of 11 patients within recent years presenting with symptoms of an acute abdomen due to AI. None of these patients were found to have a pathologic process creating a lead point. However, we found that all of them were marijuana users. In this report, we compare their management, hospital course and review of the literature discussing proposed mechanisms that suggest an association between cannabis and intussusception.

scholarly journals An Unusual Presentation of Small Bowel Intussusception

2021 ◽  
pp. 9-11
Author(s):  
Yinglin Gao ◽  
Cheikh Talal El Imad ◽  
Hai Song Kim ◽  
Vivek Gumaste
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Rare Case ◽  
Recurrent Abdominal Pain ◽  
Nausea And Vomiting ◽  
Adult Intussusception ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Small Bowel Intussusception ◽  
Intestinal Obstructions

Adult small bowel intussusception is a very rare entity that accounts for 5% of all cases of intussusception and 1%–5% of intestinal obstructions. It is more common in children but can occur in adults. It is an important etiology to consider when a patient presents with recurrent abdominal pain. The diagnosis can be challenging as symptoms are nonspecific and include abdominal pain, nausea and vomiting. This paper presents a rare case of duodenal intussusception, followed by a review of the literature discussing the diagnosis and treatment of adult intussusception.

In the Era of Routine Use of CT Scan for Acute Abdominal Vain, Should All Adults with Small Bowel Intussusception Undergo Surgery?

2009 ◽  
Vol 75 (10) ◽  
pp. 958-961 ◽  
Author(s):  
Jaisa Olasky ◽  
Ashkan Moazzez ◽  
Kaylene Barrera ◽  
Tatyan Clarke ◽  
Jabi Shriki ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Acute Abdominal Pain ◽  
Operative Management ◽  
Lead Point ◽  
Small Bowel Intussusception

In contrast to adult colonic intussusception in which malignancy is the dominant cause, small bowel intussusceptions are mostly benign. Although surgery is the accepted standard treatment, its necessity in small bowel intussusceptions identified by CT scan is unknown. Twenty-three patients from 2005 to 2008 (16 males; median age, 44 years) with acute abdominal pain and CT-proven small bowel intussusception were studied. Factors associated with the necessity for surgery were determined. Among 11 patients who were managed operatively, surgery was deemed unnecessary in two patients based on negative explorations. Follow up in 10 of 12 patients managed nonoperatively was not associated with any recurrence of intussusception or malignancy (median follow up, 14 months). The only predictor of the need for surgery was CT evidence of small bowel obstruction and/or a radiologically identified lead point, which was present in 7 of 9 (78%) patients having a necessary operation and absent in 12 of 14 (86%) with no indication for surgery (P = 0.008). All small bowel intussusceptions found on CT scan in patients with acute abdominal pain do not require operative management. CT findings of small bowel obstruction and/or presence of a lead point are indications for surgery.

scholarly journals Intussusceptions in Adults: A Retrospective Interventional Series of Cases

1970 ◽  
Vol 8 (3) ◽  
pp. 158-165 ◽  
Author(s):  
Rakesh Kr Gupta ◽  
Chandra Shekhar Agrawal ◽  
Rohit Yadav ◽  
Amir Bajracharya ◽  
Panna Lal Sah
Keyword(s):  
Small Bowel ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Clinical Features ◽  
Retrospective Review ◽  
Large Bowel ◽  
Ct Scanning ◽  
Adult Intussusception ◽  
Small Bowel Intussusception ◽  
Intestinal Obstructions

Background: Intussusception is a different entity in adults than it is in children and is usually secondary to a definable pathology. Objective: To review adult intussusception: clinical features, diagnosis and their management. Subjects and methods: A retrospective review of 38 cases of intussusception in individuals older than 18 years of age presenting to BPKIHS Dharan, Nepal from January 2003 to December 2009 was done. Results: In six years, there were thirty-eight patients of surgically proven adult intussusception. The patients. mean age was 49.6 ± 16.2 years, M: F ratio was 1.3:1. Intestinal obstructions of various extents were the commonest presentation in twenty-seven patients (71%). There were 42% enteric, 32% ileocolic and 26% colonic AI. The diagnostic accuracy of the ultrasonography was 78.5%, CT scan was 90% and colonoscopy was 100%. The pathological lesions were found in 94% of AI. Among the pathological lesion, enteric have 62% benign, 38% malignant, ileocolic have 50% benign, 50% malignant, and in colocolic 70% malignant, 30% benign. In enteric AI, 68% were reduced successfully, 25% reduction was not attempted. Of ileocolic AI, 58.3% were reduced successfully, 41.6% had resection without reduction. Of colocolic AI, 30% of them were reduced successfully before resection, 70% had resection without reduction. Conclusion: CT scanning is the most useful diagnostic radiologic method in AI. Colonoscopy is the most accurate in ileocolic and colonic AI. Small-bowel intussusception should be reduced before resection if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly malignant. Keywords: Adult intussusception (AI); Bowel obstruction; CT scan DOI: 10.3126/hren.v8i3.4208Health Renaissance, September-December 2010; Vol 8 (No.3);158-165

scholarly journals Jejuno-jejunal intussusception in an adult – a rare presentation of abdominal pain in the Emergency Department

2021 ◽  
Author(s):  
Ahmed Hasan Yousef Al Zaabi ◽  
Jasmine Abdulla Al Janahi ◽  
Salwa Najim Alremaithi ◽  
Balamurugan Rathinavelu ◽  
hasan qayyum
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Resection ◽  
Adult Intussusception ◽  
Lead Point ◽  
Rare Presentation ◽  
Proximal Small Bowel ◽  
Common Diagnosis ◽  
Contrast Ct

Abstract Background Abdominal pain is a common presentation to the emergency department (ED) and the differential diagnoses is broad. Intussusception is a more common diagnosis in children, with only 5% of cases reported in adults. 80–90% of adult intussusception is due to a well-defined lesion resulting in a lead point, whereas in children, most cases are idiopathic. Adult intussusception is also more commonly associated with malignancy, compared to children. In adults, malignancy is more common in intussusception involving the large bowel compared to intussusception in the small bowel. Case presentation We present a case of a 54-year-old lady who presented to our ED with abdominal pain and vomiting. She had multiple abdominal surgeries in the past. On examination, she had epigastric and peri-umblical tenderness. In view of her persistent abdominal pain that was refractory to analgesia, she had computed tomography (CT) of the abdomen which revealed a jejuno-jejunal intussusception and proximal small bowel obstruction. The patient had an urgent laparoscopy and small bowel resection of the intussusception segment was performed. No pathological lead point was identified on imaging or intra-operatively. The patient made a full recovery post operatively. Conclusion Our case report illustrates a rare diagnosis of abdominal pain and vomiting, presenting to the Emergency Department. With increasing accessibility to CT, most cases of adult intussusception are found incidentally on contrast CT of the abdomen and pelvis. While there is no consensus on management, it is more common for adult intussusception patients to have operative intervention, compared to childhood intussusception.

Submucosal Lipoma at the lead point of Small bowel Intussusception in an Adult

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S59-S59
Author(s):  
F Kiran ◽  
I M Asuzu ◽  
S Noreen
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Acute Mesenteric Ischemia ◽  
Distal Segment ◽  
Postoperative Recovery ◽  
Sudden Onset ◽  
Lead Point ◽  
Small Bowel Intussusception ◽  
History Of ◽  
Rule Out

Abstract Introduction/Objective Morbidity and mortality among adult patients presenting with acute abdominal pain are high, and these patients often require hospitalization with prompt surgical consultation Important differentials include small bowel obstruction from previous surgeries and hernias, acute mesenteric ischemia, and ruptured abdominal aortic aneurysm. Intussusception in adults is rare accounting for about 1% - 5% of small bowel obstructions and thus requiring a high index of suspicion for early detection. In most cases, the lead point is a benign mass, commonly a lipoma, but histopathologic examination of the resected segment is required to rule out malignancy. Methods/Case Report We present a case of a 50-year old male with a medical history of psoriasis and hypertension who was admitted on account of a 1-day history of sudden onset persistent abdominal pain with associated nausea non-bilious emesis. Physical examination reveals no fever and soft non-distended abdomen with diffuse tenderness. CT scan demonstrated long segment small bowel-small bowel intussusception with markedly edematous and dilated bowel, compatible with obstruction. The lead-point was suspected to be a 3.9cm lipoma. Segmental resection and primary re-anastomosis were performed. Gross examination revealed a 13cm segment of bowel telescoping into a distal segment with a lead-point demonstrating mucosal congestion and submucosal thickening corresponding to a well-circumscribed 3.5cm tan yellow soft lobulated mass with yellow cut surface. Histopathology was consistent with lipoma. The patient made an uneventful postoperative recovery. Results (if a Case Study enter NA) N/A Conclusion Intussusception should be kept in the differential diagnosis of adults presenting with sudden onset abdominal pain and pathologic examination of the resected segment is necessary to rule out malignancy.

scholarly journals Jejunojejunal intussusception in an adult: a rare presentation of abdominal pain in the emergency department

2021 ◽  
Vol 14 (7) ◽  
pp. e243787
Author(s):  
Ahmed Hasan Yousef Al Zaabi ◽  
Jasmine Abdulla Al Janahi ◽  
Salwa Najim Alremeithi ◽  
Hasan Qayyum
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Histopathological Examination ◽  
Operative Management ◽  
Small Bowel Resection ◽  
Adult Intussusception ◽  
Resected Specimen ◽  
Lead Point ◽  
Rare Presentation

Abdominal pain is a common presentation to the emergency department (ED) and the differential diagnoses is broad. Intussusception is more common in children, with only 5% of cases reported in adults. 80%–90% of adult intussusception is due to a well-defined lesion resulting in a lead point, whereas in children, most cases are idiopathic. The most common site of involvement in adults is the small bowel. Treatment in adults is generally operative management whereas in children, a more conservative approach is taken with non-operative reduction. We present a case of a 54-year-old woman who presented to our ED with severe abdominal pain and vomiting. CT of the abdomen revealed a jejunojejunal intussusception. The patient had an urgent laparoscopy and small bowel resection of the intussusception segment was performed. Histopathological examination of the resected specimen found no pathologic lead point and, therefore, the intussusception was determined to be idiopathic.

An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
David Muchuweti ◽  
Hopewell Mungani ◽  
Hopewell Mungani ◽  
Farai Mahomva ◽  
Edwin Gamba Muguti ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Acute Abdomen ◽  
Bowel Obstruction ◽  
Bowel Wall ◽  
Haemodynamic Instability ◽  
Small Bowel Volvulus ◽  
General Surgeons ◽  
Heavy Infestation ◽  
Emergency Abdominal Surgery

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Wide Spectrum ◽  
Internal Hernias ◽  
Mild Abdominal Pain ◽  
Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

Jewish Holiday “Tu Bishvat” or Two Cases of Small Bowel Obstruction with Dried Apricot

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Kukeev I ◽  
◽  
Replyansky I ◽  
Czeiger D ◽  
Atias S ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gastric Bypass Surgery ◽  
Surgical Removal ◽  
Cellulose Content ◽  
Lead Point ◽  
First Case ◽  
Dried Fruit ◽  
High Level

Introduction: Small bowel obstruction caused by bezoars is rare. One of the causes of phytobezoars is dried fruits. We present two cases of small bowel obstruction caused by dried apricots during Jewish holiday “Tu BiShvat”. Case Presentation: Two men, 54 and 86 years old hospitalized with acute abdomen attributed to small bowel obstruction. In the first case - intoxicated patient, due to suspicion of mesenteric ischemia underwent laparotomy. A lead point caused obstruction was found and after enterotomy whole dried apricot was removed. The patient swallowed it whole three days before hospitalization. In the second case, edentulous patient with small bowel obstruction and peritonitis underwent laparotomy. The cause of obstruction was a dried apricot swallowed whole by the patient. Discussion: Presentation of bezoar with features of acute surgical abdomen is extremely rare, accounting for only 1% of the patients. The expansion of phytobezoar that is high in cellulose content can absorb a large amount of fluid causing an obstruction of the small bowel. The treatment of small bowel obstruction caused by bezoars varies from dissolving with cellulase, papain and even Coca-Cola, followed by endoscopic and surgical removal. Conclusion: A high level of suspicion needs to exist in the presence of a history of eating dried fruit, which can cause gastrointestinal obstruction. Especially on background gastric bypass surgery and inadequate mastication.

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