Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021933 (intussusception)
 3,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intussusception is relatively rare in the adult population and differs substantially from pediatric intussusception. Most adult intussusceptions identified at surgery are caused by a definable structural lesion, a substantial proportion of which are malignant, particularly in the colon. Small bowel intussusceptions, however, have a lower prevalence of malignancy. Diagnosis of adult intussusception can be made reliably with noninvasive imaging techniques. CT is now widely regarded as the modality of choice for diagnosing intussusception in adults, but ultrasound and MR imaging have also been used effectively. Determination of the presence of a malignant lead point remains problematic because an edematous or hemorrhagic intussuscipiens may mimic a mass on each modality. Markers for bowel viability have been described but are not precise. Treatment of the persistent symptomatic intussusception in which neoplasia is suspected is surgical, and preoperative reduction is contraindicated. Transient relatively asymptomatic enteric intussusceptions discovered by imaging may not require intervention.
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PMID:Adult intussusception: diagnosis and clinical relevance. 1466 62

Two distinct mechanisms, vasculogenesis and angiogenesis implement the formation of the vascular network in the embryo. Vasculogenesis gives rise to the heart and the first primitive vascular plexus inside the embryo and in its surrounding membranes, as the yolk sac circulation. Angiogenesis is responsible for the remodeling and expansion of this network. While vasculogenesis refers to in situ differentiation and growth of blood vessels from mesodermal derived hemangioblasts, angiogenesis comprises two different mechanisms: endothelial sprouting and intussusceptive microvascular growth (IMG). The sprouting process is based on endothelial cell migration, proliferation and tube formation. IMG divides existing vessel lumens by formation and insertion of tissue folds and columns of interstitial tissue into the vessel lumen. The latter are termed interstitial or intervascular tissue structures (ITSs) and tissue pillars or posts. Intussusception also includes the establishment of new vessels by in situ loop formation in the wall of large veins. The molecular regulation of these distinct mechanisms is discussed in respect to the most important positive regulators, VEGF and its receptors flk-1 (KDR) and flt-1, the Angiopoietin/tie system and the ephrin-B/EpH-B system. The cellular mechanisms and the molecular regulation of angiogenesis in the pathological state are summarized and the differences of physiological and pathological angiogenesis elaborated.
Cancer Treat Res 2004
PMID:Vasculogenesis and angiogenesis. 1501 50

Ten-percent of all malignancies affecting the HIV(+) patient population are lymphomas. Lymphoma involving the gastrointestinal tract may be more common than anticipated in this select group of patients. Because this patient population is frequently seen by the surgeon for abdominal complaints, the diagnosis of enteric lymphoma should be entertained and the general surgeons should be aware of its frequency. We report a case of intussusception caused by enteric lymphoma in an HIV(+) patient.
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PMID:Intestinal lymphoma causing intussusception in HIV(+) patient: a rare presentation. 1527 46

The Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract, melanin pigmentation of the skin and mucous membranes, and an increased risk for cancer. The incidence of surgical complications in these patients is relatively rare, and correlates with the size and location of the polyps. Herein we report the case of a 27-year-old woman presented with episodes of abdominal pain, abdominal distention and intermittent vomiting. Moreover, multiple pigmentation of the mouth was also noted. A preoperative diagnosis of a double jejunal intussusception and jejunal occlusion was based on the findings of small bowel enema and computed tomography. The diagnosis was confirmed at laparotomy.
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PMID:Intussusception of the small bowel due to Peutz-Jeghers syndrome: a case report. 1528 92

Intussusception seldom occurs naturally in adults, but is frequently found due to an underlying disease. We present the case of a 46-year-old man with the chief complaint of repeated abdominal cramping pain, especially in the right lower quadrant, and diarrhea of 1 year's duration. Abdominal sonography and computed tomography showed ileocecal intussusception, and colonoscopy found one protruding tumor at the cecum. Biopsy of the tumor revealed malignant lymphoma cells. Due to persistent symptoms, fear of intestine obstruction caused by further intussusception, and the possibility of mesenteric vascular compression, the patient underwent laparoscopic right hemicolectomy before systemic chemotherapy. The symptoms were relieved successfully after surgery. We emphasize that the majority of adults with intussusception may have an underlying malignancy. The most important rule in treatment is avoidance of tumor emboli spread during manipulation. Therefore, a trial of reduction of the intussuscepted intestine should be prohibited.
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PMID:Laparoscopic treatment of ileocecal intussusception caused by primary ileal lymphoma. 1528 9

Peutz-Jeghers syndrome (PJS) is an unusual hamartomatous polyposis of the gastro intestinal (GI) tract, with pigmentation around lips and macules on the buccal mucosa. The case of a 10-year-old girl who presented with intussusception is reported. A polyp was found to be the cause of an invagination. Histologically it was a hamartoma. PJS is a rare syndrome inherited in an autosomal dominant pattern. Most patients have recurrent episodes of polyp induced bowel intussusception which requires repeated laparotomies. In addition, these patients have an increased risk of malignant disease in gastrointestinal and also non-gastrointestinal sites. To prevent cancer and short bowel syndrome, aggressive screening is recommended. Upper and lower endoscopy should be performed every two years from 10 years of age. Extra-intestinal surveillance for cancers, including abdominal and pelvic ultrasound, as well as testicular and breast examinations once yearly should be introduced in the second decade of life.
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PMID:Peutz-Jeghers syndrome. A case report. 1581 43

We report a case of malignant fibrous histiocytoma (MFH) metastatic to the spine. A 41-yr-old male was admitted to our hospital for radiation treatment of MFH of the spine. He began to show signs suggestive of partial small bowel obstruction. Computed tomography demonstrated jejuno-jejunal intussusception. The patient was taken to the operating room, where the diagnosis was confirmed. Partial jejunal resection was performed. The lead point of the intussusception was histologically diagnosed to be a high-grade malignant fibrous histiocytoma. We believe that the spinal lesion was the metastatic lesion and that metastasis occurred via the vessels of Adamciewicz. To our knowledge this is the first case thus reported.
Int J Gastrointest Cancer 2005
PMID:Primary malignant fibrous histiocytoma of the jejunum metastatic to the spine: report of a case. 1587 29

Intussusception occurs rarely in adults. It presents with a variety of acute, intermittent, and chronic symptoms, thus making its preoperative diagnosis difficult. CT scan of the abdomen and pelvis usually reveals the diagnosis of intussusception in adults. Surgical resection of the intussusception without reduction is the preferred treatment in adults, as almost half of both colonic and enteric intussusceptions are associated with malignancy. However, the choice and timing of operation will depend on the clinical condition of the patient and the status of the invaginating tumor. Colon cancer in young individuals is usually aggressive, with a dismal prognosis.
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PMID:An unusual presentation of colon cancer in a young individual. 1598 49

Targeted inactivation of p27(kip1) was sufficient for intestinal tumor formation in mice, but this was strictly a function of diet: tumors formed in p27(+/-) or p27(-/-) mice fed control AIN-76A diet and were increased by a western-style diet but did not develop in mice fed standard chow diet. When crossed with the Apc1638N(+/-) mouse, Apc(+/-),p27(+/-) or Apc(+/-),p27(-/-) mice not only formed twice as many tumors than the sum of the tumors from mutation at either locus alone, but on AIN76A diet also developed intestinal intussusception, a tumor-associated pathology in patients leading to intestinal blockage that has not been reported for intestinal cancer in mouse models. Moreover, the frequency of intussusception was increased when the compound mutant mice were maintained on the western diet, leading to early death. Despite this more aggressive tumor phenotype generated by inactivation of p27 than by inactivation of another cyclin-dependent kinase inhibitor, p21(WAF1/cip1), the nonsteroidal anti-inflammatory drug sulindac was still effective in inhibiting intestinal tumor formation in Apc(+/-),p27(+/-) or Apc(+/-),p27(-/-) mice, which contrasts with the abrogation of the effects of sulindac in Apc(+/-),p21(+/-) or Apc(+/-),p21(-/-) mice, indicating that p27 is not necessary for tumor inhibition by sulindac. Furthermore, tumor inhibition by sulindac was linked to the induction of p21 expression by the drug, regardless of p27 status, leading to suppression of cell proliferation and promotion of cell differentiation and apoptosis in the intestinal mucosa.
Cancer Res 2005 Oct 15
PMID:p27kip1 in intestinal tumorigenesis and chemoprevention in the mouse. 1623 Mar 99

Angiosarcoma is a rare malignant tumor which occurs frequently in the skin and soft subcutis. Moreover, primary gastrointestinal angiosarcomas are very rare. This tumor manifests as non-specific symptoms such as gastrointestinal bleeding, abdominal pain and nausea. The diagnosis is often made at an advanced stage. Surgery, chemotherapy and radiotherapy are the mainstay of treatment. However, the prognosis is very poor. We report a case of primary angiosarcoma of the small intestine presenting as recurrent gastrointestinal bleeding. A 54-year-old man was admitted with recurrent gastrointestinal bleeding. An abdominal CT scan revealed an ileo-ileal intussusception. Segmental resection was performed with ileo-ileal anastomosis. The ileal mass was diagnosed as angiosarcoma on immunohistochemical stain. He received 3 cycles of chemotherapy, but died 5 months after the diagnosis.
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PMID:[A case of primary angiosarcoma of small intestine presenting as recurrent gastrointestinal bleeding]. 1630 55


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