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Query: UMLS:C0021933 (intussusception)
 3,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An unusual case of chronic intussusception, without any digestive sign, secondary to mesenteric lymphadenitis caused by Yersinia enterocolitica is reported. Operative reduction by taxis was performed but ileopexy and antibiotic treatment were also carried out to reduce chances of recurrent intussusception.
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PMID:Chronic intussusception associated with Yersinia enterocolitica mesenteric adenitis. 146 87

Significant differences exist in the prevalence of most gastroenterological emergencies in tropical compared with temperate countries. Both ethnic and environmental (often clearly defined geographically) factors are relevant. The major oesophageal lesions which can present acutely in tropical countries are varices and carcinoma; bleeding and obstruction are important sequelae. Peptic ulcer disease (and its complications), often associated (not necessarily causally) with Helicobacter pylori infection, has marked geographical variations in incidence. Emergencies involving the small intestine are dominated by severe dehydration, and its sequelae, resulting from secretory diarrhoea, most notably cholera. However, enteritis necroticans ('pig bel' disease), paralytic ileus (sometimes caused by antiperistaltic agents) and obstruction (secondary to luminal helminths, volvulus and intussusception) are other important problems, especially in infants and children. Enteric fever is occasionally complicated by perforation and haemorrhage; the former (which is notoriously difficult to manage) is accompanied by significant mortality. Ileocaecal tuberculosis is a major cause of right iliac fossa pathology--sometimes associated with malabsorption; amoeboma is an important clinical differential diagnosis. The colon can be involved in invasive Entamoeba histolytica infection (which, like complicated enteric fever, is difficult to manage if the fulminant form, with perforation, ensues), shigellosis, volvulus and intussusception. Acute colonic dilatation occasionally follows Salmonella sp., Shigella sp., Campylobacter jejuni, Yersinia enterocolitica and rarely E. histolytica infections. Acute hepatocellular failure is a major cause of morbidity and mortality in the tropics and subtropics. It usually results from viral hepatitis (HBV, sometimes complicated by HDV, and HCV), but there is a long list of differential diagnoses. Hepatotoxicity resulting from herbs, chemotherapeutic agents or alcohol also occurs not infrequently. Chronic liver disease and its sequelae (often long-term results of viral hepatitis) are commonplace. Haematemesis and hepatocellular failure are usually very difficult to manage due to a lack of sophisticated support techniques in developing countries. Invasive hepatic amoebiasis usually responds well to medical management; however, spontaneous perforation can occur and the consequences of this are serious. Pyogenic liver abscess, although far less common than amoebic 'abscess', carries a bad prognosis whatever the method(s) of management. Hydatidosis and schistosomiasis also involve the liver, and helminthiases are important in the context of biliary tract disease. Gall stones are unusual in most tropical settings. Acute pancreatitis is overall unusual, but chronic calcific pancreatitis can present as an acute abdominal emergency.
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PMID:Gastroenterological emergencies in the tropics. 176 26

During a 20-month period 55 strains of Aeromonas species were isolated from 53 children with diarrhea. The isolation rate of 2.5% for Aeromonas compared with the rates of 4.5% for Shigella, 3.3% for Salmonella, 2.7% for Campylobacter and 0.05% for Yersinia. In 45 children Aeromonas was the sole bacterial enteropathogen identified. Aeromonas was also isolated from 2 (0.5%) of 380 asymptomatic children. Despite its known lack of identifiable virulence properties, Aeromonas caviae was the most prevalent species, accounting for 69% of the isolates. None of the A. caviae strains produced cytotoxin by the 51Cr release assay and 12.5% were weakly enterotoxigenic by the infant mouse assay. All of the Aeromonas sobria and 71% of Aeromonas hydrophila were positive for both toxins. Ninety-two percent of the children with Aeromonas-associated diarrhea were younger than 3 years; 84% of the cases were seen between May and October. The majority of the children had an acute onset of watery diarrhea. Fever and vomiting were most commonly associated with the isolation of A. sobria. Eight children had chronic or intermittent diarrhea lasting for weeks to months before consultation; A. caviae was the isolate in all these cases. Several complications possibly related to Aeromonas intestinal infection were observed. These included Gram-negative bacteremia, intussusception, internal hernia strangulation, hemolytic uremic syndrome and failure to thrive in patients with chronic diarrhea.
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PMID:Aeromonas-associated gastroenteritis in children. 334 Apr 60

After a short review of literature about the few previous reports a case of intussusception associated with Yersinia enterocolitica in a 11 month-old infant is reported. The causal significance of mesenteric lymphoadenomegaly is discussed. Intussusception as the first clinical sign of Yersinia infection is suggested.
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PMID:[Intestinal invagination and Yersinia enterocolitica infections]. 653 29

We tried to isolate verotoxin-producing Escherichia coli (VTEC) on sorbitol-MacConkey (SMAC) agar and in part by the polymerase chain reaction (PCR) method from sporadic enteritis patients with bloody stools and intussusception patients who came to three pediatric clinics in the Fukuoka area from October 1990 to September 1994. VTEC O157:H7 strains were isolated from 6 (10.5%) of 57 patients with bloody stools, Campylobacter spp. 15 (26.3%), Salmonella spp. 14 (24.6%) and Yersinia enterocolitica 2. We were not able to detect VT genes by PCR from 11 of 20 patients from whose stools no causative bacteria were isolated. Massive fresh bloody stools following frequent watery diarrhea were typical of the VTEC enteritis patients. Only 1 patient had fever and 2 had leukocytosis, but the C-reactive protein in all of them was below 1+. The VTEC strains were isolated during the summer season, 1 in June, 2 in July, and 3 in September. Since in the area O157:H7 appeared to be the most prevalent VTEC serotype, SMAC is very useful for screening VTEC in bloody stools. VTEC seems to be a rare pathogen of intussusception because the organisms were detected from none of the 30 patients.
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PMID:[Isolation of verotoxin-producing Escherichia coli from pediatric patients suffering from enteritis with bloody stool and intussusception]. 761 13

Surgical specimens (n = 48) or autopsy case materials (n = 15) were studied from 63 pediatric patients (44 males and 19 females) with intussusceptions involving the ileocecal junction (38 patients [60.3%]), ileum (16 patients [25.4%]), jejunum (four patients [6.3%]), and other sites (five patients [8%]). Lymphoid hyperplasia formed the leading edge in 32 cases (51%); other lesions included Meckel diverticulum (six cases), lymphoma (four cases), adenomyomatous hamartoma (four cases), cecal duplication cyst (three cases), ectopic pancreas (two cases), congenital bowel malformation (two cases), and examples of Peutz-Jeghers polyp, lymphangioma, leiomyoma, and inflammatory fibroid polyp (one case each). In six cases there was no associated lesion. Immunohistochemical evaluation for adenovirus was performed in 16 of the 32 cases in which lymphoid hyperplasia was present, and five reactive cases were identified; characteristic intranuclear adenovirus inclusions were visible on hematoxylin-eosin-stained specimens from all five of these cases as well as in five additional cases (a total of 10 of 32 cases [31.2%]). The presence of Yersinia sp was confirmed by serology in one case having characteristic histologic findings. Fourteen deaths were attributable to consequences of intussusception; these patients were younger (median and mean ages, 5.5 and 8.6 months; age range, 1 month to 3.5 years) than the surviving patients (median and mean ages, 2.0 and 3.2 years; age range, 6 days to 14 years), but were not more likely to have evidence of adenovirus infection.
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PMID:Intussusception, adenovirus, and children: a brief reaffirmation. 811 17

Intussusception associated with Yersinia pseudotuberculosis infection was developed in three boys; two of them had a history of drinking untreated water. All intussusceptions were localized at the ileocolic region, and all patients completely recovered with Gastrografin enema and supportive treatment without complication and operation.
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PMID:Intussusception associated with Yersinia pseudotuberculosis infection. 892 96

Search of the autopsy files of the Department of Histopathology at the Women's and Children's Hospital (WCH), Adelaide, Australia for cases of intussusception from January 1961 to December 1995 revealed two deaths due to intussusception out of a total of 4,384 autopsies (0.05%). Both cases occurred in infants (aged five months and six months respectively) who had only non-specific and apparently minor manifestations of illness, until precipitate deterioration occurred. The intussusceptions were ileo-ileal and ileocaecal in location, respectively. A total of 204 cases of intussusception were found in a search of 28,123 surgical pathology cases (0.73%) at the WCH over the 20-year period from 1976 to 1995. Mesenteric lymphadenopathy was found in 16 cases (including one with possible Yersinia infection), Meckels diverticulum in 14, isolated gastric/pancreatic heterotopia in two, cystic fibrosis in two and Henoch-Schonlein purpura in one. Although it has been shown that unexpected death is more likely to occur in older children with purely small intestinal intussusception, the current cases demonstrate that unexpected death may occur at any age, with intussusception at any level. The autopsy assessment of deaths due to intussusception requires careful evaluation of cases for evidence of local or systemic disease, particularly given the hereditary nature of certain predisposing conditions. Careful review of the presenting history is also required to assess the quality of care received by the child in the time preceding death.
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PMID:Sudden death and intussusception in infancy and childhood--autopsy considerations. 1121 22

Patients who are homozygous for thalassemia major are at risk for Yersinia enterocolitica infections. We present a case of a 4-year-old child with intussusception of the terminal ileum whose past medical history was significant for beta-thalassemia. His monthly blood transfusions for this condition may have put him at risk for Y enterocolitica enterocolitis. The pathogenesis of this disease relates to the role of iron as an essential growth factor for Yersinia, and this patient's transfusions left him in an iron-overloaded state, despite treatment with Desferal. Our patient's unusual presentation of intussusception was secondary to the mass effect caused by lymphoid hyperplasia, specifically hypertrophied Peyer's patches in the ileum caused by Y enterocolitica infection. To our knowledge, this is the first such case of intussusception caused by Yersinia to be reported.
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PMID:Intussusception due to Yersinia enterocolitica enterocolitis in a patient with beta-thalassemia. 1169 9

Patients with acute abdominal pain are a great challenge to the radiologist. The clinical diagnosis is classically unreliable, resulting in both negative laparotomies as well as ill-advised surgical delay in a large number of patients. Ultrasound offers a non-invasive way to decrease both false-negative and false-positive diagnoses in this category of patients. This article focuses on the role of sonography in the diagnosis of acute conditions of the gastrointestinal tract tract such as appendicitis, sigmoid diverticulitis, Crohn's disease, colitis, infectious ileocecitis caused by Yersinia, Campylobacter or Salmonella, right-sided colonic diverticulitis, bowel malignancy presenting acutely, small bowel obstruction, intussusception, omental infarction, and epiploic appendagitis. The sonographic spectrum of these conditions as well as possible pitfalls are discussed using illustrative case histories.
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PMID:Ultrasound of acute GI tract conditions. 1170 19


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