Surgical management of intussusception in adults

Surgical management of intussusception in the adul

  1. In the patient with intussusception of the small intestine, an associated primary malignancy is uncommon. Initial reduction, followed by limited surgical resection, is the preferred treatment. Surgical resection without reduction is favored only when an underlying primary malignancy is clinically suspected
  2. In the patient with intussusception of the small intestine, an associated primary malignancy is uncommon. Initial reduction, followed by limited surgical resection, is the preferred treatment. Surgical resection without reduction is favored only when an underlying primary malignancy is clinically suspected. ASJC Scopus subject area
  3. Controversy concerning the appropriate surgical management of intussusception in the adult prompted review of the Mayo Clinic's experience with this uncommon entity. During the last 23 years, 48 patients had documented intussusception: 24 instances of intussusception originating in the small intestine and 24 instances of intussusception.
  4. The etiology, clinical features, and management of intussusception differ markedly between adults and children. Intussusceptions are much more common in children, with adults accounting for about 5% of all cases [2]
  5. INTRODUCTION. Intussusception is the telescoping of a proximal segment of bowel wall into the lumen of an adjacent, usually distal segment. It is commonly encountered in the small bowel of children, where the aetiology is largely benign and non-operative treatment usually successful ().In contrast, intussusception in adults is rare ().Colonic involvement represents up to 50% of cases, and in.

Surgical management of intussusception in the adult — Mayo

This report aims to outline the importance of high clinical suspicion regarding intussusception in adults presenting with abdominal pain in the emergency department. Case report: This is a retrospective review of three cases of adult ileocecal intussusception that were treated in a single surgical department in three years (2015-2018) In adults, a diagnosis of intussusception is often difficult and not often made before laparotomy. 1 A demonstrable etiology is found in 70% to 90% of cases in adult intussusceptions, and about 40% of them are caused by a primary or secondary malignant neoplasm. 2-8 Computed tomography (CT) scan is now widely used in the evaluation of abdominal masses and nonspecific abdominal pain and may be the first examination performed in a patient in whom an intussusception is present Treatment of intussusception in adults is surgical without attempts at hydrostatic reduction. Optimal surgical procedure depends on the anatomic location, present of a lead point, and local factors, such as edema, inflammation, and ischemia of involved bowel The most common form of treatment for Intussusception in Adults is surgery. Often, adults with intussusception have large structural issues in the intestines and surgery is necessary. Unlike intussusception in small children, air and barium enemas are not frequently used as treatment options in adults

Surgical management of intussusception in the adult

  1. Older children and adults more often have a surgical lead point to the intussusception and require operative reduction. A decreased rate of operative intussusception management is noted in..
  2. The surgeon will free the portion of the intestine that is trapped, clear the obstruction and, if necessary, remove any of the intestinal tissue that has died. Surgery is the main treatment for adults and for people who are acutely ill. In some cases, intussusception may be temporary and go away without treatment
  3. Intussusception is a surgical emergency, and delays in treatment can lead to high mortality. This disorder is managed by an interprofessional team that consists of a radiologist, emergency department physician, general surgeon, and possibly a gastroenterologist
  4. e the causes and management of intussusception in adults. A retrospective review of patients more than 18 years of age with a diagnosis of intestinal intussusception between January 1996 and December 2003 was conducted
  5. Once intussusception is diagnosed, the next step is to attempt reduction (to push the intestine back) using a liquid contrast enema or air contrast enema (the same tests that are used for diagnosis). This is a radiologic procedure, not a surgical procedure, and your child doesn't need anesthesia
  6. Surgical treatment can be difficult in gastroduodenal and coloanal intussusceptions, sometimes requiring innovative techniques. This paper presents the diagnosis and management of four cases of adult intussusception, followed by review of the literature. http://dx.doi.org/10.1136/pgmj.2004.02274

Surgical Management of Intussusception in the Adult

Surgical versus conservative management of adult

Intussusception and distended loops of small intestine were palpable by per-rectal examination in only 23% and 50% of affected adult cattle, respectively (Constable et al., 1997). Mestry et al. (2011) conducted a study in 12 bovines affected with intestinal obstruction and per-rectally palpated elongated mass in more than 50% of animals and. The key point is to remember that in contrast to children, the management is usually surgical and all adult patients with intussusception should have a surgical consultation. Sources/Further Reading - Lindor, RA, et al. Adult intussusception: presentation, management, and outcomes of 148 patients Intestinal intussusception in adults is uncommon. It is different from child intussusception in various aspects, and almost 90% of all cases are associated with pathologic lead points. Because of the significant risk of malignancy, surgical resection is generally recommended [ 5 ] Intussusception is invagination of a proximal segment of bowel into the distal segment in telescopic manner. Although intussusception is common among children, intussusception secondary to terminal ileal endometriosis in an adult is a very rare encounter. We present such a case of intussusception in a Sri Lankan female. A 43 year old Sri Lankan female presented to the surgical casualty unit.

Intussusception has long been discussed in medical literature. Barbette of Amsterdam described the first case in 1674 [].In 1742, Cornelius Henrik Velse performed the first successful operation on adult intussusception [].Intussusception is a rare form of bowel obstruction in adults, which is defined as the telescoping of a proximal segment of the gastrointestinal tract, into the lumen of the. Intussusception in adults is a rare cause of abdominal pain that is often associated with organic pathology. We describe a case of ileocolic intussusception revealing a cecal adenocarcinoma in a young woman successfully managed by laparoscopic-assisted surgery adhering to oncological principles. A 30-year-old woman with a family history of colon adenocarcinoma in a young brother presented to. a surgical procedure performed on the intestine Increased motility in a segment of intestine (hypermotility) which is adjacent to a segment that has lack of motility (ileus) can cause the hypermotile segment to telescope into the segment with ileus, resulting in an intussusception Intestinal intussusception is very rare in adults and, unlike in children, it is due to an organic cause, mainly benign or malignant tumors, in 90 % of cases. Recurrent intussusception in an adult is even more exceptional, and in the case reported it was due to repeated occurrence of intestinal pseudopolyps, which is exceptional according to the literature Management of Asymptomatic Intussusception in Patients with Melanoma *Stephanie Douglas, Charles Cha, *Deepak Narayan Yale University School of Medicine, New Haven, CT. 1. Objective. Asymptomatic intussusception has increasingly been observed incidentally in adults undergoing CT scan and may represent a benign, transient finding

Intussusception is more common in children than in adults. It mainly occurs in children 6-18 months. Roughly 30% of all cases occur in children older than 2 years.. The condition is rare in. The management of intussusception in adults is primarily surgical, given the high association of malignant pathology. A PubMed search of intussusception due to bezoar revealed only one case report (Calero et al., 2014), and in that report, the patient underwent small bowel resection, with the finding of intussusception of the mid-jejunum due to.

Coronal reformatted computed tomography image

Adult intussusception is rare, accounting for only 5% of all cases that often need surgical resection due to the risk of intestinal necrosis or malignancy [].Of all the adult intussusceptions, 38-44% have occurred in the colon and 52-55% in the small intestine [].Adult colonic intussusception mostly occurs in the sigmoid colon, transverse colon, and the cecum [] Management and outcomes of small bowel obstruction in older adult patients: a prospective cohort study. Can J Surg 2014; 57:379. Ozturk E, van Iersel M, Stommel MM, et al. Small bowel obstruction in the elderly: a plea for comprehensive acute geriatric care

Unlike pediatric intussusception, intestinal intussusception is infrequent in adults and it is often secondary to a pathological condition. The growing use of Multi-Detector Computed Tomography (MDCT) in abdominal imaging has increased the number of radiological diagnoses of intussusception, even in transient and nonobstructing cases. MDCT is well suited to delineate the presence of the. Adult intussusception is a rare but challenging condition. Preoperative diagnosis is frequently missed or delayed because of nonspecific or sub-acute symptoms. We present the case of a sixty-two year old gentleman who initially presented with pseudo-obstruction. Computerised tomography displayed a jejuno-jejunal intussusception, which was treated by primary laparoscopic reduction Intussusception is the most common cause of intestinal obstruction in patients aged 5 months to 3 years. Intussusception can account for as many as 25% of abdominal surgical emergencies in children younger than 5 years, exceeding the incidence of appendicitis. Causes. In most cases, however, no cause can be identified for intussusception Intussusception occurs when a portion of the small or large intestine slides forward into itself, like a telescope. An intussusception can block flow through the intestines and also limit the blood supply to that area of intestine. It is most commonly seen in children who are younger than 1 year

Intussusception is rarely seen in newborn infants. Boys develop intussusception four times more often than girls. Although 80 percent of the children who develop the condition are less than 2 years old, intussusception can also occur in older children, teenagers and adults #### Summary points Rectal prolapse is an extrusion of the full thickness of the wall of the rectum beyond the anal verge. Internal rectal prolapse, or intussusception, is defined as a full thickness prolapse of the rectum that does not protrude through the anus. Rectal prolapse and intussusception often coexist with a rectocoele (herniation of the rectovaginal septum anteriorly into the. Adult intussusception is a rare clinical condition worldwide. It contributes to less than 5% of all cases of intussusception. Few studies have been conducted in low-income countries compared to high-income countries; particularly Sub-Saharan Africa. Based on anecdotal evidence, the authors hypothesized that the condition is not as rare in a Sub-Saharan setting in comparison with western countries

Intussusception is considered a medical emergency, but it's treatable with both nonsurgical and surgical approaches. The risk of developing this intestinal obstruction tends to diminish as a. Intussusception is most common in babies younger than age 1, and about 90 percent of cases occur in children younger than age 3. 11. Intussusception is rare in adults. Only about 5 percent of cases of intussusception occur in adults. 11. Intussusception is more common in boys than in girls. 11. What are the complications of intussusception Bowel intussusception in adults remains a rare and constant diagnostic challenge for surgeons. It has an incidence of around 2-3 new cases per million per year, and its primary cause is benign or malignant neoplasms of the small bowel and colon. This report aims to outline the importance of high clinical suspicion regarding intussusception in adults presenting with abdominal pain in the.

Adult Intussusception Detected at CT or MR Imaging: Clinical-Imaging Correlation. David M. Warshauer , Joseph K. T. Lee. David M. Warshauer, Joseph K. T. Lee. Author Affiliations. 1 From the Department of Radiology, University of North Carolina School of Medicine, Campus Box 7510, Rm 2016 Old Clinic Bldg, Manning Dr, Chapel Hill, NC 27599-7510 Surgical management of intussusception in the adult. Ann Surg 1981; 193:230-236. Crossref, Medline, Google Scholar; 7 Weillbaecher D, Bolin JA, Hearn D, Ogden W. Intussusception in adults: review of 160 cases. Am J Surg 1971; 121:531-535. Crossref, Medline, Google Scholar; 8 Catalano O. Transient small bowel intussusception: CT findings in adults Adult intussusception caused by Peutz-Jeghers syndrome occurs very rarely. The purpose of this study was to analyze the clinical characteristics, preoperative diagnosis, and surgical management of Peutz-Jeghers syndrome associated with acute intussusception in adult patients Surgical management of intussusception in the adult. Ann Surg. vol. 193. 1981. pp. 230 Vanek, VW, Al-Salti, M. Acute pseudo-obstruction of the colon (Ogilvie's syndrome): an analysis of.

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Adult colonic intussusception: Surgery still the best

Surgical Surgery should be reserved for patients with debilitating symptoms from constipation that have significant nega-tive effects on their quality of life. A brief overview of the various surgical options follows. Colostomy or Ileostomy Patients with normal colonic transit and severe refractor Intussusception is a common abdominal emergency in children with significant morbidity. Prompt diagnosis and management reduces associated risks and the need for surgical intervention. Despite widespread agreement on the use of contrast enema as opposed to surgery for initial management in most cases, debate persists on the appropriate contrast. Intussusception is an emergency requiring rapid treatment. Treatment in children is typically by an enema with surgery used if this is not successful. Dexamethasone may decrease the risk of another episode. In adults, surgical removal of part of the bowel is more often required. Intussusception occurs more commonly in children than adults

Intussusception is the most common cause of intestinal obstruction in children less than 3 years and it is idiopathic, while in adults and older children, pathological etiology e.g. polyp, lymphoid hyperplasia or hematoma usually precipitates the condition Intussusception is a serious condition that occurs when a portion of the intestines moves inside itself (similar to how a telescope works) and causes a blockage. It is more common in infants and children than it is in adults. Intussusception can be life-threatening and requires immediate treatment

Bowel intussusception in adults: a report of three

Intussusception is the invagination of a proximal part of intestine into the adjacent distal part. Reported frequently in children, it forms a rare presentation in adults and can be difficult to diagnose pre operatively. Imaging modalities are increasingly being used for preoperative diagnosis with almost all cases in adults being secondary to an intestinal lesion. Intraoperative management of. About 70-90% of intussusceptions in adults have a lead point, which is a well-defined pathological abnormality. 2,5,14 Neoplasms are the most common etiology of adult intussusception, and malignant lesions account for approximately 60% of all neoplasms causing intussusception. 15 In general, the majority of lead points in the small bowel.

The Diagnosis and Treatment of Adult Intussusception

The management of duodenal intussusception depends on the underlying cause and severity of symptoms. If the cause is malignancy then pancreatoduodenectomy is required. It is a benign disease such as adenoma or polyp or diverticulum as seen in the present case then simple endoscopic or surgical excision of the lesion is curative AIM: To optimize the preoperative diagnosis and surgical management of adult intussusception (AI). METHODS: A retrospective review of the clinical features, diagnosis, management and pathology 41 adult patients with postoperative diagnoses of intussusception was conducted Since malignancies are the primary cause for most intussusception cases, most surgeons agree to a surgical approach, with ~60% of interventions being executed in an emergency setting [1, 3]. Reduction of the small bowel in order to avoid surgery and save bowel length is dangerous due to the possibility of bowel perforation and migration of. In adult intussusception, surgical exploration remains essential. Nevertheless, controversy persists concerning the optimal surgical management strategy. The principle of resection without reduction is well established[ 11 ]

Management Of Intestinal ObstructionSurgical Management of Biliary Tract Disease – Vet360

Small bowel obstruction - Surgical Treatment - NCBI Bookshel

Unlike the more common idiopathic intussusception found in children, intussusception in adult patients still remains a surgical disease. The type of surgical procedure depends on the patient's medical history (previous operations, malignancy) and intra-operative findings . The optimal surgical management of intussusception in adult patients is. Management of intussusception usually begins with resuscitation and when there are no contraindications, the patient is prepared for a non-surgical reduction either by liquid or air enema.1 Various studies have reported that, with air reduction, laparotomy could be avoided in 70%-90% of infantile intussusception cases.4 7 8 However, the. Begos DG, Sandor A, Modlin I: The diagnosis and management of adult intussusception. Am J Surg. 1997, 73: 88-94. Article Google Scholar 6. Nagorney DM, Starr MG, Mcilrath DC: Surgical management of intussusception in the adult. Ann Surg. 1981, 193: 230-236. 10.1097/00000658-198102000-00019

Intussusception in Adults - DoveMe

Only 5% of all cases of intussusception are described in the adult population, where it accounts for only 1-5% of all adult intestinal obstructions. In children, intussusception is most often primary and benign whereas in adults, nearly 90% of intussusception cases are due to a pathologic process that serves as a lead point including. Sanders GB, Hagan WH, Kinnaird DW: Adult intussusception and carcinoma of the colon. Ann Surg. 1958, 147 (6): 796-804. PubMed Central CAS PubMed Google Scholar 6. Nagorney DM, Sarr MG, McIlrath DC: Surgical management of intussusception in the adult. Ann Surg. 1981, 193 (2): 230-6. 10.1097/00000658-198102000-00019

Object moved to here The following considerations apply to ileocaecal intussusception only (i.e., an intussusception that involves the distal ileum, typically with the caecum, ascending and transverse colon). Primary treatment is always by contrast enema (gas or liquid) unless there are signs of peritonitis, which necessitates early surgery Diagnosis and management of . ADULT TRANSIENT ENTEROENTERIC INTUSSUSCEPTION: Computed tomography plays a critical role. Background • In recent years, there is an emerging concept of transient intussusception - figure 1. • Transient intussusception previously is thought to be rare, however with progressive use of . computed tomography (CT The main issues in the management of adult intussusception are: (1) When proceed with surgical exploration; (2) Once the surgical approach is the treatment of choice, whether attempt intraoperatively reduction or proceed direct to resection of the affected segments; and (3) Once the surgical approach is the treatment of choice, it should be.

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Intussusception Treatment & Management: Approach

In contrast to children, where intussusception is usually idiopathic, in adults, an underlying cause is found in 90% of cases.4 The most common aetiologies of intussusception in an adult are a benign polyp, malignancy (particularly adenocarcinoma or lymphoma), MD and Crohn's disease Intussusception occurs primarily in infants (boys more often than girls) but can also occur in adults and older children. The primary symptoms of intussusception include abdominal pain and vomiting. Early diagnosis and treatment of intussusception are essential to save the intestine and the patient Adult intussusception is a rare entity in contrast to children's intussusception. There is no sex predilection, and the median age of presentation is in the sixth to seventh decade of life. 6 Adult intussusception represents 0.003% to 0.02% of all hospital admissions. 1,

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Intussusception - Diagnosis and treatment - Mayo Clini

Intussusception is the movement or 'telescoping' of one part of the bowel into another. The proximal bowel segment is referred to as the intussuceptum whilst the distal segment as intussucipiens. (1) Epidemiology. The peak incidence of intussusception is between 5-7 months of age (4) and rare to occur after 2 years (2) Intussusception is a pediatric condition that rarely presents in adults. In this article, we report a case of a 36 year-old man initially presenting with abdominal pain and rectal prolapse, however, surgical reduction of the rectal prolapse did no relief his symptoms. Physical examination, abdominal plain film, barium enema and colonoscopy confirmed the presence of a large intra-abdominal mass. Surgical resection is recommended in nearly all cases of adult intussusception inducted by GISTs because of the high prevalence of structural anomalies and the relatively high risk of the underlying malignancy. This case presents an unusual malignant cause of adult intussusception tumors of the small intestine that may have a malignant potential Intussusception is rarely encountered in adults, accounting for just 5% of all occurrences and 1% of bowel obstructions. In up to 90% of episodes of adult intussusceptions, operative intervention is required secondary to pathological lead points. Prior to the current report, only three cases of total ileocolic intussusception with rectal prolapse in adults have been described in the world.

CT Abdomen/Pelvis without contrastPPT - Pediatric Airway Management PowerPoint PresentationKetan VAGHOLKAR | Professor (Full) | Padmashree Dr

Intussusception is a telescoping of one portion of the bowel into another portion which results in obstruction to the passage of the intestinal contents and inflammation and impaired blood flow to the parts of the intestinal walls that are pressing against one another. If not treated, tissue necrosis, intestinal perforation, and peritonitis may occur. . The symptoms of intussusception include. Intussusception is an uncommon cause of intestinal obstruction and more than 95% of cases occur in the paediatric age group [].Intussusception in adults is a rare pathology its incidence is around 2-3 per 1000,000 per year [].Due to this rare nature of the disease there are no large scale/multi-centre studies or meta-analyses published to investigate the management of adult intussusception rectal intussusception or a traumatic solitary rectal ulcer, al-though these associations have never been clearly proven. 1-3 Rectal prolapse is rare and is estimated to occur in ≈0.5% of the general population overall, although the fre-quency is higher in females and the elderly, and women aged ≥50 years are 6 times more likely as men to. Intussusception is a form of intestinal obstruction in which a segment of the bowel prolapses into a more distal segment. It is an uncommon condition in children older than 2 years and causes intestinal obstruction. On the contrary of adult intussusception, childhood intussusception does not usually happen on a lead point of a malignant organic lesion Background: Bowel intussusception represents an infrequent and challenging condition in adult patients. Preoperative diagnosis and treatment strategies often remain difficult especially in emergency patients. Primary reduction of intussusception before surgical resection is discussed controversially in adult patients and at the moment there is no consensus about the best treatment in literature Intussusception is one of the less common causes of intestinal obstruction among adults. It is usually covert (concealed) in its clinical presentation. The ileo-colic type with accompanying anal protrusion is extremely rare. The case at hand is that of both an ileo-colic intussusception with anal protrusion, in the presence of a persistence of both the ascending and descending mesocolons; a.

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