scholarly journals Clinicopathological Feature of Adult Small Bowel Intussusception Diagnosed and Managed by Double-Balloon Enteroscopy : A Single Centre Study

Author(s):  
Won Shik Kim ◽  
Beom Jae Lee ◽  
Ah Young Yoo ◽  
Seong Min kIM ◽  
Seung Han Kim ◽  
...  

Abstract Background: Adult small bowel intussusception usually has an aetiology that leads to small bowel obstruction. Here, we aimed to identify the clinicopathological features of adult small bowel intussusception managed with Balloon-Assisted Enterosopy (BAE) and to explore the clinical usefulness of BAE for the management of small bowel intussusception.Method: We retrospectively analysed the clinical data of 13 patients who were diagnosed with adult small bowel intussusception at Korea University Guro Hospital between 2010 and 2019.Results: The type of intussusception was ileoileal in eight (61.5%) patients and jejunal-jejunal in five (38.5%) patients. Eight cases of small bowel intussusception (61.5%; five idiopathic causes, two Peutz-Jeghers polyps, and one Crohn’s disease) were successfully managed with BAE. The remaining five patients underwent laparoscopic small bowel resection due to management of the primary aetiology (two diffuse large B-cell lymphoma, one lipomatosis, one Peutz-Jeghers polyps, and one angiomyolipoma).Concusions: In many cases, adult small bowel intussusception had a benign and idiopathic aetiology. The diagnosis and treatment of adult small bowel intussusception with BAE may reduce the requirement for small bowel resection in selected patients.

2021 ◽  
Vol 17 (2) ◽  
pp. 126-130
Author(s):  
Seo Ree Kim ◽  
Sang Hoon Chun ◽  
Jong Youl Jin ◽  
Tae-Geun Gweon ◽  
Hayemin Lee ◽  
...  

There have been several reports of complications of small bowel lymphoma, such as bleeding, obstruction, and perforation, often require emergency surgery. It is hardly showed complications of bleeding and wound dehiscence for diffuse large B cell lymphoma with distal ileum involvement, which needed urgent surgery and medical management. A 65-year-old man with diffuse large B-cell lymphoma with distal ileum involvement experienced both intestinal bleeding and perforation during the course of treatment. As the patient was diagnosed with stage III disease, resection before chemotherapy was not considered due to the resulting delay in chemotherapy, which necessitated sufficient tissue healing. Chemotherapy is important when treating small bowel lymphoma, complications such as bleeding and perforation should always be considered for the treatment of small bowel lymphoma, and surgery is necessary in this situation. After surgery of the small bowel, subsequent chemotherapy could cause wound dehiscence and perforation; therefore, adequate recovery time should be given before chemotherapy.


Endoscopy ◽  
2015 ◽  
Vol 47 (S 01) ◽  
pp. E526-E528 ◽  
Author(s):  
Paul Kröner ◽  
Pavan Mankal ◽  
Abdelaziz Elhaddad ◽  
Wenjing Shi ◽  
Jean Abed ◽  
...  

2021 ◽  
Author(s):  
Seo Ree Kim ◽  
Sang Hoon Chun ◽  
Jong Youl Jin ◽  
Tae-Geun Gweon ◽  
Hayemin Lee ◽  
...  

Abstract Background: There have been several reports of complications of small bowel lymphoma, such as bleeding, obstruction, and perforation, which require emergency surgery. It is hardly showed complication of bleeding and wound dehiscence for diffuse large B cell lymphoma with distal ileum involvement, which needed urgent surgery and medical management. Chemotherapy is also important when treating small bowel lymphoma, but complications such as bleeding and perforation should always be kept in mind.Case presentation: A 65 year-old man with stage III diffuse large B-cell lymphoma of the activated-B cell (ABC) type with distal ileum involvement experienced both intestinal bleeding and perforation during the course of treatment. As the patient was diagnosed with stage III disease, resection before chemotherapy was not considered due to the resulting delay in chemotherapy, which necessitated sufficient tissue healing. Conclusion: As shown in this case, complications such as bleeding and perforation should always be considered for the treatment of small bowel lymphoma, and surgery is necessary in this situation. After surgery of the small bowel, subsequent chemotherapy could cause the wound dehiscence and perforation; therefore, adequate recovery time should be given before chemotherapy.


1970 ◽  
Vol 2 (2) ◽  
pp. 67-72
Author(s):  
Gustavo Nunes Medina Coeli ◽  
Afonso Carlos da Silva ◽  
Rodrigo Ribeiro Tiengo ◽  
Guilherme Carlos da Silva ◽  
Leandro Urquiza Marques Alves da Silva ◽  
...  

Introdução: Os tumores do intestino delgado são raros, de diagnóstico difícil e quando malignos, têm prognóstico ruim. Os linfomas primários representam menos de 2% de todos os tumores gastrointestinais malignos, sendo na sua maioria do subtipo de células B. Casuística: Foi relatado um caso raro de linfoma de intestino delgado em uma paciente do sexo feminino de 77 anos, que procurou atendimento médico com sintomas inespecíficos e um quadro anêmico. Os exames radiológicos foram fundamentais para esclarecimento, diagnóstico e propedêutica. Os marcadores tumorais foram negativos e as provas de atividade inflamatória, positivas. Na internação, a paciente teve piora súbita do quadro clínico, necessitando de cirurgia. No intra-operatório, foi identificado lesão perfurativa em jejuno proximal de aspecto ulcerado com aderências na bexiga e fundo do útero. A paciente não evoluiu bem, falecendo após três dias. A patologia confirmou Linfoma Não Hodgkin Difuso de Grandes Células B, com elevado índice de proliferação celular. Discussão: O diagnóstico radiológico pré-operatório do tumor do intestino delgado só é obtido em um pequeno percentual de pacientes sintomáticos. Estudos por imagem demonstram aspectos morfológicos do tipo infiltrativo, polipóide ou aneurismático. Geralmente, ocorre acometimento circunferencial da alça, com espessamento irregular das pregas, de extensão variável. Conclusão: O objetivo deste estudo foi documentar um raro tumor do intestino delgado do tipo Linfoma Não-Hodgkin Difuso de Grandes Células B, multicêntrico, de difícil diagnóstico e com rápida evolução dos sintomas, que culminaram com quadro de obstrução intestinal aguda, necessitando de cirurgia de emergência.  Palavras chave: Tumor de intestino delgado, linfoma de intestino, obstrução.


2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1422-S1423
Author(s):  
Hanan T. Lodhi ◽  
Sadat Iqbal ◽  
Qulsoom Hussain ◽  
Zarak H. Khan ◽  
Faisal Inayat ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Mahboubeh Rahmani ◽  
Stephanie Halene ◽  
Mina L. Xu

Context. Intravascular large B-cell lymphoma (IVLBCL) is a rare non-Hodgkin B-cell lymphoma with a poor prognosis. While typically described as comprising large atypical cells restricted to the lumina of small blood vessels, it can show variability in cell size. Objective. To report the clinicopathologic features of the IVLBCL with small cell morphology and discuss the practical implications of our findings. Design. We searched our archives for all IVLBCL diagnosed in our institution for the last 25 years (1992–2017). Slides were reviewed independently by two hematopathologists. Results. We found a total of 11 cases of IVLBCL. Bone marrow, brain, lymph node, pericardium, small bowel, and fallopian tube and ovary were the organs in which the lymphoma was initially diagnosed. One of the cases initially diagnosed in the marrow showed intrasinusoidal involvement by a small cell lymphoma; the diagnosis was confirmed by random skin biopsies showing intravascular large cells with the same phenotype. Retrospective review of the liver on this case also showed the intrasinusoidal involvement by the disease consisting of small cells. In another case, IVLBCL that was initially diagnosed in a small bowel biopsy was retrospectively found in a breast biopsy, but with small cell morphology. Conclusions. Our findings suggest that, in the presence of high clinical suspicion, IVLBCL should be high in the differential diagnosis when lymphoma is predominantly intravascular, even when the tumor cells are small. A timely diagnosis of this entity can be critical. Hence, awareness of a small cell variant of IVLBCL should be increased.


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