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

Vomiting or its lesser stages-anorexia, nausea-is a prime symptom of the most serious surgically curable diseases of childhood. In the newborn, when vomitus is green, abdomen scaphoid, and erect roentgen view shows air-fluid levels in stomach and duodenum with gas beyond, partial duodenal obstruction is present and midgut volvulus with malrotation is likely enough to justify immediate exploration. In infancy, vomiting is a clear sign of intussusception when associated with intermittent colicky pain, palpable mass and "currant-jelly" feces. These symptoms are not always present, and if there is blood in the feces, barium enema study must follow. In further doubt, exploration may be justified. In childhood, a common early symptom of appendicitis is vomiting accompanied by pain without any complete remission. Constipation is frequent but diarrhea may occur and contribute to an impression of gastroenteritis. Complete and repeated physical examination, with a history of the above symptoms, should lead to correct diagnosis.
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PMID:Vomiting as a symptom of serious disease in infants and children. 1382 64

Intussusception is a rare condition in adults. We report a case of a 69-year-old woman referred to our institution for lower left quadrant abdominal pain, weight loss, and occasional episodes of constipation and rectal hemorrhage. The patient underwent plain radiography, ultrasonography, and magnetic resonance imaging of the pelvis. The final diagnosis was colocolic intussusception due to a neoplastic lead point.
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PMID:Adult colocolic intussusception: demonstration by conventional MR techniques. 1516 Jul 52

A 48-year-old man presented with abdominal pain, constipation and irritability one month after starting phenytoin treatment for a generalized seizure. He was hypertensive, tachycardic (BP 174/98, heart rate (HR) 100 bpm supine) and hypovolaemic. Abdominal CT demonstrated transient jejunal intussusception and infarction of the left kidney. Urinary porphobilinogen levels were increased and genetic analysis confirmed the diagnosis of variegate porphyria. Because of ongoing postural hypotension, the patient underwent further autonomic investigations. Levels of blood pressure (MBP), HR and muscle sympathetic activity (MSNA) were increased during the acute attack compared to recovery (131 versus 105 mmHg, 100 versus 60 bpm, 88 versus 26 bursts min(-1)). HR and MSNA did not increase during phase II Valsalva, whereas stroke volume (SV) decays were exaggerated (deltaMBP-56 versus 0-31 mmHg and SV 25% versus 40% baseline). Baroreflex failure causing increased sympathetic activity, decreased sympathetic and parasympathetic rapid responses, loss of splanchnic capacitance and renal salt wasting were the likely mechanisms for postural hypotension. Increased sympathetic activity may also have caused intussusception and focal renal vasoconstriction, both of which may be underdiagnosed causes of abdominal pain in acute porphyria.
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PMID:Variegate porphyria presenting with acute autonomic dysfunction, intussusception and renal infarction. 1518 Jan 90

Adequate therapy of obstructed defecation (pelvic outlet obstruction) is often challenging, as the etiology and clinical symptoms include a wide range of disorders. Standardized diagnostic assessment has to differentiate between obstructed defecation caused by either pelvic outlet obstruction or slow transit constipation. Additionally, morphologic changes of colon, rectum, or the pelvic floor have to be separated from functional disorders. Providing defecography or dynamic MR of the pelvic floor, common causes of outlet obstruction such as sigmoidoceles, in which surgery is indicated, and rectal prolapse can be diagnosed with high accuracy. However, the diagnosis and therapeutic options in symptomatic rectocele and intussusception are controversial. Patients with functional disorders such as rectoanal dyssynergia are candidates for conservative treatment (biofeedback). To identify patients who will benefit from surgery for obstructed defecation, careful patient selection remains the crucial issue in diagnostic assessment.
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PMID:[Obstructed defecation]. 1525 46

Thickening of the internal anal sphincter (IAS) is observed in chronic idiopathic constipation (IC) and solitary rectal ulcer syndrome (SRUS), where it has been correlated with the presence and severity of rectal intussusception. Alternatively, thickened IAS may be a feature of the obstructed megarectum in a similar way to the hypertrophy of bladder neck seen in dyssynergic bladders. The aim of this study was to investigate the significance of thickening of the IAS in children with chronic IC and to determine any association between the thickened IAS and anorectal manometry findings and patient's symptoms. A total of 144 children were admitted for investigations and treatment of chronic IC and evaluated prospectively between April 2001 and April 2003. IAS thickness was measured by endosonography using B&K axial endosonic probe type 1850 with a 10-MHz rotating transducer. The thickness of IAS was measured at 3, 6, and 9 o'clock, and the mean value of the three measurements was used for analysis. Functional assessment was done by anorectal manometry pressure studies under ketamine anaesthesia. A validated symptom score (SS) was used to assess the severity of symptoms. The sum of SS ranged between 0 and 65. Spearman's rho two-tailed test was used to correlate the thickness of IAS with patients' symptoms and anorectal manometry findings. Results were expressed as median and range and p-value of less than 0.05 was considered significant. Of 144 children, 84 were boys, median age 8.1 years (range 3.1-15). Soiling was present in 137 (94%) patients, delay in defecation in 132 (91%), and a palpable megarectum on abdominal examination in 117 (80%). The median duration of symptoms and duration of laxative treatment were 4 years (range 0.3-14.5) and 3.3 years (0.2-13.5), respectively. The average severity score for soiling, delay in defecation, palpable megarectum, and the total SS were 8 (range 0-10), 5 (0-10), 2 (0-12), and 33 (11-51), respectively. The median thickness of IAS was 0.9 mm (range 0.3-2.8) and the median resting anal sphincter pressure was 54 mmHg (19-107). The median amplitudes of rectal and anal sphincter contraction were 3 mmHg (1-25) and 9 mmHg (1-35), respectively. The thickness of IAS correlated significantly with total symptom severity score (r=0.31, p=0.0001), soiling score (r=0.28, p=0.001), megarectum score on abdominal palpation (r=0.29, p=0.001), size of megarectum on manometry (r=0.36, p=0.0001), amplitude of rectal contraction (r=0.23, p=0.007), and age of patient (r=0.55, p=0.0001). There was also a significant correlation between the amplitude of rectal and anal sphincter contraction (r=0.32, p=0.0001). There was no correlation between thickness of IAS and resting anal sphincter pressure and amplitude of anal sphincter contraction on anorectal manometry study. A total of 24 children had myectomy of thickened and overactive IAS in addition to the medical treatment of their chronic IC. The histology examination of myectomy specimen with eosin and haematoxylin staining and histochemical acetylcholine esterase staining showed smooth muscle fibres and ganglion cells. Thickening of IAS correlates significantly with duration and severity of symptoms, size of megarectum, and amplitude of rectal contraction. The pathogenesis is secondary to the continuous presence of faeces in the rectum, resulting in chronic abnormal stimulus to the IAS, which leads to hypertrophic changes in the rectum wall and IAS.
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PMID:Thickening of the internal anal sphincter in idiopathic constipation in children. 1545 28

Colonic lipomas are relatively uncommon clinical entity, although they are among the most common nonepithelial benign tumors of the colon. They may produce abdominal pain, diarrhea, constipation, hemorrhage, and intussusception. We report a case of a 56-year-old man who was suffering from abdominal pain and 4 weeks of intermittent diarrhea. Ultrasound examination of the abdomen revealed an abdominal mass in the right upper quadrant. Computed tomography showed a well-circumscribed intraluminal mass in the ascending colon, measuring 5 cm in diameter, with density value equal to fat. During laparoscopic surgery we found a colocolic intussusception, which we reduced laparoscopically, and performed a laparoscopically assisted right colectomy. The resected colon revealed a 6 cm wide lipoma within the ascending colon. Histology confirmed the diagnosis of benign lipoma. Aspects of preoperative diagnosis and treatment are discussed, and we review the literature.
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PMID:Laparoscopically assisted resection of an ascending colon lipoma causing intermittent intussusception. 1589 12

Lipoma of the colon is a relatively rare benign tumor. A case with intermittent subacute colon obstruction due to a giant lipoma of the cecum is reported. A 51-year-old woman presented with intermittent, abdominal crampy pain in the right upper and lower quadrants, accompanied by alternative episodes of diarrhea and constipation. She had had similar symptoms over the last three months. A double-contrast barium enema showed a large (approx. 7 cm in diameter) polypoid mass occluding the lumen of the cecum and the ascending colon. Colonoscopy revealed a submucosal mass suspected of benign tumor but too large for endoscopic resection. Surgery revealed a hard elongated mass in the right colon, which telescoped into the transverse colon and caused colo-colonic intussusception. Right hemicolectomy was performed and pathology documented a mature, submucosal lipoma of the cecum. Six years after the surgery, the patient has not showed any of the previous symptoms. Along with a review of the literature, the incidence, diagnosis complications and treatment of colonic lipomas are discussed.
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PMID:Giant submucosal lipoma of the cecum: report of a case and review of literature. 1640 Mar 57

Obstructive defecation is observed in approximately half of all patients with functional constipation. Functional constipation has been related to alterations in intestinal motility (slow transit constipation) and to pelvic floor disorders leading to obstructive defecation associated with anatomical alterations of the pelvic floor (rectocele, posterior perineal hernia, enterocele and sigmoidocele, internal rectal intussusception, occult mucosal prolapse, solitary rectal ulcer and descending perineum syndrome), or obstructive defecation without anatomical alterations (pelvic floor dyssynergy or anismus). The diagnostic methods used (history and physical examination, colonic transit time, balloon expulsion test, proctography, anorectal manometry and electromyography) are reviewed. Conservative medical treatment and the indications for surgical treatment and its results are also discussed.
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PMID:[Obstructive defecation. Diagnostic methods and treatment]. 1647 17

Abdominal pain and gastrointestinal symptoms such as vomiting or diarrhea are common chief complaints in young children who present in emergency departments. It is the emergency physician's role to differentiate between a self-limited process such as viral gastroenteritis or constipation and more life-threatening surgical emergencies. Considering the difficulties inherent in the pediatric examination, it is not surprising that appendicitis, intussusception, and malrotation with volvulus continue to be among the most elusive diagnoses. This article reviews both the self-limited and more life-threatening gastrointestinal conditions that may present in the emergency department.
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PMID:Abdominal pain in children. 1648 87

A 34-year-old woman presented at 19 weeks in her third pregnancy with abdominal pain and hyperemesis. This was her third admission during the pregnancy for similar complaints. A few days after admission an exacerbation in her pain was noted, in particular on eating or lying down, and a firm and mobile epigastric mass could be palpated separate from her uterus. The differential diagnosis was a hernia or a degenerating pedunculated fibroid. Sonography revealed a mass separate from the uterus with an appearance consistent with intussusception. Magnetic resonance imaging confirmed the diagnosis. A limited right hemicolectomy was performed. The final diagnosis was adenocarcinoma of the colon. It is difficult to diagnose intussusception during pregnancy. The presenting symptoms of nausea, vomiting, abdominal pain and constipation are common in pregnancy and the displacement of the bowel by the gravid uterus hampers examination. Intussusception is very rare in adults and generally it is associated with tumors. Preoperative diagnosis is difficult but possible with accurate imaging.
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PMID:Intussusception: a rare cause of abdominal pain in pregnancy. 1695 24


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