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.

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.

scholarly journals Adult intussusception associated with mesenteric Meckel’s diverticulum and antimesenteric ileal polyp

2019 ◽  
Vol 12 (9) ◽  
pp. e230612
Author(s):  
Adrian K McGrath ◽  
Fatimah Suliman ◽  
Noel Thin ◽  
Ashish Rohatgi
Keyword(s):  
Small Bowel ◽  
Primary Anastomosis ◽  
Meckel’S Diverticulum ◽  
Small Bowel Resection ◽  
Meckel's Diverticulum ◽  
Adult Intussusception ◽  
Histopathological Analysis ◽  
Lead Point ◽  
Benign Polyp ◽  
Antimesenteric Border

Meckel’s diverticulum is the most common congenital abnormality affecting the gastrointestinal tract, affecting 4% of the general population. It is classically located on the antimesenteric border of the ileum within 100 cm of the ileocaecal valve. Complications may include haemorrhage, bowel obstruction, diverticulitis, perforation and malignancy. This report explores the case of intussusception in an adult, in association with a mesenteric Meckel’s diverticulum and adjacent benign polyp. A 40-year-old man presented with acute abdominal pain, affecting the central abdomen and both flanks. CT imaging revealed small bowel intussusception, with either a Meckel’s diverticulum or polyp acting as a lead point. Intraoperatively, the intussusception had already resolved; however, an inflamed outpouching was identified on the mesenteric border of the ileum, with a firm mass palpable within the bowel lumen. A 70 mm small bowel resection and primary anastomosis were performed. Histopathological analysis confirmed an inflamed Meckel’s diverticulum as well as an adjacent diverticulum comprising a benign polyp.

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.

Somatostatin receptor-effector system in rat pancreatic acinar membranes after subtotal enterectomy

1995 ◽  
Vol 268 (2) ◽  
pp. E343-E348
Author(s):  
I. Alvaro-Alonso ◽  
B. Colas ◽  
J. P. Esteve ◽  
C. Susini ◽  
E. Arilla
Keyword(s):  
Small Bowel ◽  
Receptor Binding ◽  
Protein Interactions ◽  
Bowel Resection ◽  
Somatostatin Receptor ◽  
Small Bowel Resection ◽  
Receptor Binding Site ◽  
Proximal Small Bowel ◽  
Effector System ◽  
Receptor Number

In the present study we found that exocrine pancreatic hyperplasia observed after proximal small bowel resection is accompanied by an increase in pancreatic somatostatin (SS) content at 1 mo and an increase in the number of SS receptors at 2 wk and 1 mo after intestinal surgery. At 6 mo after small bowel resection SS content and SS receptors had returned to control values. However, the original increase in SS receptor number was accompanied by a decrease in the ability of SS to inhibit forskolin-stimulated adenylyl cyclase (AC) activity. In addition, the ability of 5'-guanylylimidodiphosphate (a nonhydrolyzable GTP analogue) to inhibit SS receptor binding was decreased in pancreatic acinar membranes from enterectomized rats at 2 wk and 1 mo after jejunoileal resection. These data suggest that there is an abnormality in the integrity of SS receptor binding site-G protein interactions and would explain the decreased inactivation of AC by SS at 2 wk and 1 mo after proximal small bowel resection.

scholarly journals Endometriosis of the appendix causing small bowel obstruction in a virgin abdomen

2019 ◽  
Vol 12 (7) ◽  
pp. e230496 ◽  
Author(s):  
Joseph Do Woong Choi ◽  
Michael Yunaev
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Oestrogen Receptor ◽  
Surgical Intervention ◽  
Prior History ◽  
Good Recovery ◽  
History Of

A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.

scholarly journals Effect of ileal autotransplantation on cholesterol, bile acids, and biliary lipids in pigs with proximal small bowel resection

Hepatology ◽  
1997 ◽  
Vol 25 (6) ◽  
pp. 1315-1322 ◽  
Author(s):  
M Pakarinen ◽  
T A Miettinen ◽  
P Kuusanmaki ◽  
P Vento ◽  
T Kivisto ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bile Acids ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Biliary Lipids ◽  
Proximal Small Bowel

scholarly journals High-Fat Diet Enhances Villus Growth During the Adaptation Response to Massive Proximal Small Bowel Resection

2013 ◽  
Vol 18 (2) ◽  
pp. 286-294 ◽  
Author(s):  
Pamela M. Choi ◽  
Raphael C. Sun ◽  
Jun Guo ◽  
Christopher R. Erwin ◽  
Brad W. Warner
Keyword(s):  
Small Bowel ◽  
High Fat Diet ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
High Fat ◽  
Proximal Small Bowel ◽  
Adaptation Response

Effects of bile and pancreatic secretions on intestinal mucosa after proximal small bowel resection in rats

1980 ◽  
Vol 58 (9) ◽  
pp. 1117-1123 ◽  
Author(s):  
Monique D. Gélinas ◽  
Claude L. Morin
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Pancreatic Juice ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Sprague Dawley ◽  
Ileal Mucosa ◽  
Distal Small Intestine ◽  
Proximal Small Bowel

After proximal small bowel resection the remaining small intestine undergoes adaptive hyperplasia. In the present study, the relative contributions of bile and (or) pancreatic juice to adaptive intestinal hyperplasia following proximal resection was studied. Using male Sprague–Dawley rats a 50% proximal intestinal resection was done starting 10 cm distal to the beginning of the jejunum. The animals were also subjected to diversion of bile and (or) pancreatic secretions to the distal ileum at 18 cm proximal to the ileocecal junction. After 8 days gut and mucosal weights, mucosal proteins, and DNA were measured in the duodenojejunum (gut segment proximal to the resection anastomosis) and in the ileum (first half of the small bowel segment distal to the diversion site). The results indicate that (1) in rats fed either chow (Purina rat chow) or a chemically defined diet diversion of pancreaticobiliary secretions to the ileum significantly stimulated ileal mucosa growth whereas no changes were observed in the duodenojejunum, (2) in rats fed a chemically defined diet neither bile nor pancreatic juice affected ileal mucosa when separately diverted to the ileum, and (3) pancreatic juice draining into the duodenum while bile was diverted to the ileum induced hypoplastic changes in the duodenojejunum. The present study suggests that following jejunectomy the regulation of mucosal growth by pancreatic and bile secretions is different in the proximal and distal small intestine. Pancreaticobiliary secretions are trophic for the ileum. However, in the proximal gut bile offers protection against a direct or indirect catabolic action of pancreatic juice.

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