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

A case of inflammatory fibroid polyp of the sigmoid colon is presented. This is the eight case of this type of polyp in the colon and, to the best of our knowledge, the first one involving the sigmoid and producing intussusception. Symptomatology of the inflamed fibroid polyp in this part of the gut closely simulates gastrointestinal malignancy. The treatment is surgical excision of the polyp, or colonoscopic resection when it is possible. Intraoperative colonoscopy helps the surgeon to localize the lesion and to role out the existence of other lesions.
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PMID:Inflammatory fibroid polyp of sigmoid colon. 52 55

Between 1966 und 1975 42 children and 46 adults were operated on Meckel's diverticulum. The diverticulum is explained as one of the possible disturbances during regression of ductus omphaloentericus. The appendicitis-like symptomatology correlates to the involvement of gastric and colonic mucosa as well as heterotopic exo- and endocrine tissue of the pancreas in the wall of the diverticulum. In 34% complications were due to inflammation, perforation, bleeding, intussusception, volvulus, gut-strangulation with ileus, ulcer, neoplasia or lesion by foreign bodies. 4 out of 88 patients died. Preoperative diagnostic fails in 75%, therefore in every case the distal gut should be inspected and every diverticulum should be resected.
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PMID:[Clinical importance of Meckel's diverticulum]. 108 17

Melanoma frequently disseminates to the gastrointestinal tract, being found post-mortem in 60 per cent of patients with disseminated disease, while during life it is diagnosed in only 4 per cent. During the period 1981-87, 835 melanoma patients were referred and 30 developed complaints caused by gastrointestinal metastatic melanoma. Twenty-three patients were treated surgically. The interval between treatment of the primary melanoma and detection of intestinal involvement was a median of 34 months (range 2-87 months). In four patients recurrence in the gut was the first evidence of dissemination. Major complaints were nausea and vomiting, abdominal pain, signs of anaemia, and blood in the stools. Complications were bleeding (ten cases), ileus due to intussusception (five cases), bowel perforation (four cases) and cholecystitis (one case). The metastases, mainly localized in the small bowel, were removed by relatively simple procedures. Symptoms were reduced in 19 patients. Two patients died after operation: one from sepsis due to suture leakage, the other from pneumonia and a cerebrovascular accident. Of the remaining patients, 16 survived a median of 7.5 (range 0.7-32.0) months. Five patients are still alive 72, 72, 70, 7 and 2 months after the metastasectomy, three of whom are tumour-free. The actuarial 5-year survival of all patients is 19 per cent. These results support surgical intervention for patients with complaints and/or complications attributable to gastrointestinal metastatic melanoma.
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PMID:Surgery for melanoma metastatic to the gastrointestinal tract. 168 96

Diagnosis of gut duplications are often only made intraoperatively as they are uncommon and do not feature strongly in the differential diagnoses. A case of caecal cystic duplication mimicking intussusception is discussed with the aim of improving diagnostic accuracy in future cases. A 7 month old boy presented with the classical triad of abdominal pain, bleeding per rectum and a palpable mass. Barium enema revealed a mass in the caecum suggestive of an intussusceptum. Repeated attempts at hydrostatic reduction were unsuccessful as the mass was immobile. Laparotomy revealed cystic duplication of the caecum without intussusception. The bleeding per rectum was due to an ulcer in the colonic epithelium overlying the cyst.
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PMID:Cystic duplication of the caecum mimicking intussusception. 178 8

A study of 42 consecutive children with acute intussusception was undertaken. The emphasis was on the time taken for surgical referral in relation to the presenting symptom. Operative findings and outcome revealed late referral (greater than 72 h) in cases presenting with diarrhoea and bleeding per rectum. A higher incidence of gangrenous gut and irreducibility of intussusception was found in the ileoileal variety of intussusception. Some interesting facts about the aetiology have also been noted. Rupture of intussuscipiens was also encountered.
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PMID:Acute intussusception: referral in relation to presentation and aetiology. 231 36

Intestinal obstruction is a common postoperative complication and is usually related to peritoneal adhesion formation. A less well-recognized cause is postoperative intussusception (POI). Thirty-six instances of POI in children (aged 1 month to 18 years) were treated between 1970 and 1987. POI followed Nissen fundoplication in 9 patients, neuroblastoma resection in 5, small-bowel procedures in 4, inguinal herniorrhaphy in 3, pull-through procedures in 3, ureterostomy in 2, thoracic procedures in 2, ventral hernia in 1, nephrectomy in 1, hepatic resection in 1, Heller myotomy in 1, ventriculo-atrial shunt in 1, and gastrocystoplasty in 1. Initial symptoms included bilious vomiting or increased nasogastric drainage (after initial return of gut function) in 26 patients, abdominal distension in 24, irritability in 10, intermittent pain in 7, palpable abdominal mass in 2, rectal bleeding in 2, and lethargy in 1. The symptoms occurred 1 to 24 days (mean, 8 days) after the initial surgery. Plain abdominal radiographs revealed multiple air-fluid levels in 31 and an "adynamic ileus" in five patients. Barium contrast techniques could successfully reduce two ileocolic and one distal ileo-ileal lesions. The remainder necessitated operative management. Manual reduction was possible in 29 cases, and four children with diagnostic delay required bowel resection and an anastomosis for intestinal necrosis. The site of intussusception was ileo-ileal in 23 patients, jejunojejunal in 6, ileocolic in 5, and jejuno-ileal in 2. The diagnosis of POI should be considered in children with signs of bowel dysfunction in the early postoperative period. Contrast studies are of limited value, since most cases are confined to the small bowel. A high index of suspicion and prompt laparotomy will usually allow manual reduction of the lesion. Diagnostic delay may result in bowel necrosis.
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PMID:Postoperative intussusception: experience with 36 cases in children. 317 73

A consecutive series of 58 patients with idiopathic constipation and 20 control subjects were studied by evacuation proctography and measurements were made of changes during rectal expulsion. A wide range was found in the control group. The anorectal angle, pelvic floor descent, and the presence or size of an anterior rectocele did not discriminate between the control and patient groups. Internal intussusception was rare. Among constipated patients, the only significant differences from normal were in the time taken to expel barium and the amount of barium remaining in the distal rectum. The majority of control subjects (15 of 20) evacuated most of the barium within 20 seconds whereas 45 of 58 constipated patients took a longer time. Using the area of barium on a lateral view of the rectum as a measure, 19 of 20 control subjects evacuated at least 60 percent of the barium from the distal 4 cm of the rectum compared with only 25 of 58 patients. A varying degree of defecatory impairment was thus established among many patients with constipation. The patients were subdivided into those with a normal or abnormal whole gut transit rate as an indication of colonic function, and those who did or did not need to digitally evacuate the rectum as a clinical manifestation of an anorectal disorder. No obvious differences were found between these subgroups using the parameters measured.
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PMID:Radiologic studies of rectal evacuation in adults with idiopathic constipation. 334 75

Obstructed defaecation in the descending perineum syndrome has been attributed to anterior mucosal prolapse. Manometric and radiological measurements together with evacuation proctograms in 49 patients with obstructed defaecation and normal whole gut transit times were carried out and compared in a total of 25 controls. Proctography delineated four groups: (I) puborectalis accentuation, n = 11; (II) rectal intussusception, n = 25; (III) anterior rectal wall prolapse, n = 11; (IV) rectocele, n = 2. The anorectal angle at rest, maximum basal sphincter pressures and the rectoanal inhibitory reflex did not differ between the groups and controls. Group III achieved a greater increase in anorectal angle on straining than controls. Groups II and III exhibited significant perineal descent below the pubococcygeal line whereas group I did not. In perineal descent intussusception was the commonest morphological abnormality associated with obstructed defaecation. Isolated anterior mucosal prolapse was not observed, making local treatment aimed at reducing its bulk questionable.
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PMID:An analysis of rectal morphology in obstructed defaecation. 336 Dec 19

A case of ileocolic intussusception, associated with mid-gut volvulus and malrotation with bowel necrosis is reported. There is evidence to suggest that the intussusception preceded the volvulus.
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PMID:Intussusception, volvulus and malrotation. 386 74

In reviewing the records of almost 1000 infants and children with intussusception in two children's hospitals over the last 25 yr, there have been seven bowel perforations during attempted hydrostatic barium enema reduction of an intussusception. Except for one instance, these have all occurred during the last 6 yr. The infants were all 6 mo old or less and most had a preceeding viral illness. Only 4 of the 7 had pain, all vomited, in only 2 was a mass felt and all but 1 had rectal bleeding. The duration of these signs and symptoms was longer than 36 hr with most ill for 3 or 4 days. All seven infants had abdominal x-rays that showed complete small bowel obstruction. Once the intussusception was suspected, barium enema reduction was attempted without excessive hydrostatic pressure and not for a prolonged time; all the ileocolic intussusceptions were met in the transverse colon with only a minimal reduction produced. It was at this time that a perforation was suddenly noted. All infants required immediate right hemicolectomy for the area (s) of colonic necrosis. Postoperatively, there were two wound infections, a volvulus which left the child with a short gut and another infant suffered severe brain damage. These babies seem to fit a pattern in which they are younger and sicker longer than the average infant with an intussusception, and have a complete small bowel obstruction. These facts may be a warning that such infants are at increased risk for a barium enema bowel perforation.
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PMID:Colon perforation during attempted barium enema reduction of intussusception. 725 34


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