Diagnosis and Surgical Management of Intestinal Intussusception by Open Lumina Technique in Dairy Heifers (Bos taurus)

The present study was conducted in ten dairy heifers (Bos taurus) suffering from intestinal intussusception. All these cases exhibited the clinical signs of bouts of colicky pain for 6-12 hours followed by anorexia and cessation of faeces. In all cases, the onset of disease was between 72-120 hours. Per-rectal palpation revealed spiral-shaped mass and distended intestinal loops. Ultrasonographically, distended loops, ileus, passive movement of ingesta and presence of peritoneal fluid were consistent findings. The diagnosis of intestinal intussusception was made on the basis of clinical signs, per-rectal palpation and trans-abdominal ultrasonography. Further it was confirmed on full abdominal right flank exploratory laparotomy. All the heifers were subjected for standing right flank laparotomy under linear infiltration of local anaesthesia followed by exteriorization and resection of intussucepted intestinal mass. The side-to-side entero-anastomosis was done by open lumina technique using gastro-intestinal anastomotic (GIA) stapled devices. Signalment, duration of surgery and anastomotic time were recorded in all cases. Thus, Intestinal intussusception in dairy heifers was diagnosed on the basis of clinical signs, per-rectal palpation, trans-abdominal ultrasonography which was further confirmed by full abdominal right flank exploratory laparotomy. The GIA staples applied for side-to-side entero-anastomosis by open lumina technique took less total surgical and anastomotic time. Moreover, there was reduction in tissue trauma/manipulation and in contamination by intestinal contents. The closure of bowel was easy and secured. GIA staples can be used effectively for entero-anastomosis in cattle affected with intestinal intussusception.

Intermittent intestinal intussusception in patients with mesenteric lymphadenitis in the ileocecal angle

Introduction. At present, lymphadenopathy – as a cause of idiopathic intestinal intussusception in little children - comes to the fore. However, intestinal intussusception in case of destructive mesenteric lymphadenitis in combination with lymphoid hyperplasia of the ileocecal angle ( what does not exclude lymphoma intraoperatively) is extremely rare in clinical practice.Purpose. To present a therapeutic and diagnostic algorithm in intestinal intussusception which was caused by the “volumetric“ abdominal lymphadenopathy.Case Report. A 3-year-old boy was admitted by the ambulance with recurrent abdominal pain, single episode of vomiting and no stool for 4 days. The ultrasound examination revealed intermittent ileocecal intussusception. The risk factor which had triggered the disease was an acute respiratory viral infection complicated with purulent mesenteric lymphadenitis and lymphoid hyperplasia with ulcerative lesions of the mucous membrane in the ileocecal junction. Laparoscopic desinvagination with lymph node removal and colonoscopy with ladder biopsy were performed. A differential diagnostics of nonspecific lymphadenopathy, Burkitt’s lymphoma and Crohn’s disease was made. Immunohistological examination intraoperatively was made; examination of the biopsy material excluded tumor and inflammatory bowel disease (IBD). The inflammatory process regressed under conservative therapy (antibacterial, anti-inflammatory and antispasmolytic) ; there were no any recurrent intussusception episodes within one-year follow-up.Conclusion. Successive ultrasound, laparoscopic and colonoscopic examinations followed by the immunohistological analysis of intraoperative and biopsy material allowed to put a correct diagnosis and, thereby, to minimize surgical aggression in ileocecal intussusception which was accompanied by volumetric lymphadenopathy.

Adult Intestinal Intussusception Caused by the Gastrojejunostomy Tube: An Endoscopically Treatable Phenomenon

Adult duodenoduodenal intussusception is extremely rare due to the retroperitoneal fixation of the second, third, and fourth parts of the duodenum. A majority of clinically significant intussusception with identifiable etiologies is typically neoplastic with more rare causes including retained food and indwelling enteral tubes, specifically with gastrojejunostomy (GJ) tubes. Herein, we discuss the case of a 23-year-old male who developed duodenoduodenal intussusception upon a PEGJ placement with associated gastroduodenal dilation and telescope phenomenon. To the best of our knowledge, there are no reports of intussusception found to be caused by GJ tubes in the adult population. The reported patient was found to have a 4-cm enteroenteric intussusception without obstruction or ischemia with bowel thickening proximal to the pathology. Although adult intussusception cases are typically managed surgically, we were able to reduce the intussusception via endoscopy due to rapid diagnosis upon presentation and intervention before the bowel wall could be compromised.

Intestinal intussusception and progressive anemia due to pyogenic granuloma of the ileum: a case report

Background Pyogenic granuloma is a benign vascular tumor, usually occurring on the skin or in the oral cavity. Small intestinal pyogenic granuloma is extremely rare, but intestinal intussusception due to the tumor is even rarer. Only 3 cases have been reported in the English literature at this writing. Case presentation An 86-year-old woman presented with abdominal pain and vomiting. Laboratory data discovered anemia. Contrast-enhanced computed tomography revealed small bowel obstruction due to intestinal intussusception. After decompression by long tube for 1 week, the obstruction did not improve and the anemia got worse. Therefore, laparoscopic assisted small bowel resection was performed as a diagnostic therapy. Pathology confirmed the diagnosis of pyogenic granuloma. The postoperative course was uneventful and the patient was discharged 10 days after surgery. Conclusions We experienced a case of intestinal intussusception and progressive anemia due to pyogenic granuloma of the ileum. Although the condition is extremely rare, surgeons must take into consideration the tumor in similar cases, and complete surgical resection is required.