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Sample records for intussusception

  1. Intussusception - children

    Science.gov (United States)

    ... Viral infection Englarged lymph node in the intestine Polyp or tumor The reason for the problem is more likely to be found in older children. Intussusception can affect both children and adults. However, ...

  2. Prolapsed ileocolic intussusception

    African Journals Online (AJOL)

    Resection and anastomosis were performed in six cases, sigmoid colostomy was performed in one case, and reduction by milking without resection was performed in three cases. All the patients recovered well. Conclusion Prolapsed intussusception is a rare presentation of intussusceptions; its diagnosis is easy but may be ...

  3. INTUSSUSCEPTION - A RARE ETIOLOGY

    Directory of Open Access Journals (Sweden)

    Mariana Branco

    2017-02-01

    Discussion / Conclusions: The clinical case described is intended to alert to the importance of investigating an underlying disease in some children and adolescents with intussusception. In this case the study led to the diagnosis of cystic fibrosis

  4. Jejunogastric intussusception diagnosis and management.

    Science.gov (United States)

    Wheatley, M J

    1989-08-01

    Jejunogastric intussusception is a rare complication following gastrojejunostomy, Bilroth II partial gastrectomy, and Roux-en-Y gastrojejunostomy. We report a recent patient with a retrograde gastrojejunal intussusception, the most common of the four anatomic variants of jejunogastric intussusception. It may present acutely as a surgical emergency with ischemic small bowel or chronically, with severe postprandial discomfort. Surgical correction is mandatory although controversy exists as to the most appropriate corrective procedure.

  5. Functional Disorders: Rectoanal Intussusception

    OpenAIRE

    Weiss, Eric G.; McLemore, Elisabeth C.

    2008-01-01

    Rectoanal intussusception (RI) is a telescoping of the rectal wall during defecation. RI is an easily recognizable physiologic phenomenon on defecography. The management, however, is much more controversial. Two predominant hypotheses exist regarding the etiology of RI: RI as a primary disorder, and RI as a secondary phenomenon. The diagnosis may be suspected based on clinical symptoms of obstructive defecation. Diagnostic modalities include defecography as the gold standard. Dynamic pelvic m...

  6. Cannabis intake and intussusception: an accidental association?

    Directory of Open Access Journals (Sweden)

    Alberto Fernández-Atutxa

    Full Text Available Most intussusception cases in adults have an organic cause and their treatment is surgical. In some cases, there is no injury associated with intussusception and we can opt for conservative management. In our clinical practice we have shown the presence of intussusceptions in the absence of structural damage associated with chronic cannabis with a good course after conservative management. We describe three cases of recurrent intussusception in cannabis users, suggesting a relationship between cannabis use and the incidence of intussusception.

  7. The imaging of intussusception

    International Nuclear Information System (INIS)

    Byrne, A.T.; Goeghegan, T.; Govender, P.; Lyburn, I.D.; Colhoun, E.; Torreggiani, W.C.

    2005-01-01

    Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. It is relatively common in children and is the second most common cause of an acute abdomen in this age group. It is much less common in adults and accounts for less than 5% of cases of mechanical small bowel obstruction. Whereas the diagnosis is usually already suspected in children before imaging, it is often made unexpectedly in adults. In addition, although in children there is usually no specific underlying cause, an underlying lead point is often present in adults. Plain film radiography, barium studies and ultrasound imaging play major roles in both the diagnosis and management of this condition, and it is increasingly common for the diagnosis to be made by CT and MRI, particularly in adults. This pictorial essay reviews the imaging features that may be found in patients with bowel intussusception. As well as describing the imaging features of the more commonly used tests, we also stress the role of emerging technologies such as MRI using ultrafast half-fourier sequences with single shot turbo spin echo

  8. The imaging of intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Byrne, A.T. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland)]. E-mail: angelabyrenx@hotmail.com; Goeghegan, T. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Govender, P. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Lyburn, I.D. [Department of Radiology, Frenchay Hospital, Bristol (United Kingdom); Colhoun, E. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Torreggiani, W.C. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland)]. E-mail: william.torreggiani@amnch.ie

    2005-01-01

    Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. It is relatively common in children and is the second most common cause of an acute abdomen in this age group. It is much less common in adults and accounts for less than 5% of cases of mechanical small bowel obstruction. Whereas the diagnosis is usually already suspected in children before imaging, it is often made unexpectedly in adults. In addition, although in children there is usually no specific underlying cause, an underlying lead point is often present in adults. Plain film radiography, barium studies and ultrasound imaging play major roles in both the diagnosis and management of this condition, and it is increasingly common for the diagnosis to be made by CT and MRI, particularly in adults. This pictorial essay reviews the imaging features that may be found in patients with bowel intussusception. As well as describing the imaging features of the more commonly used tests, we also stress the role of emerging technologies such as MRI using ultrafast half-fourier sequences with single shot turbo spin echo.

  9. Intussusception of the vermiform appendix.

    Science.gov (United States)

    Dickson-Lowe, Richard A; Ibrahim, Sherine; Munthali, Lamios; Hasan, Fazal

    2015-07-16

    Appendicitis is a common presentation to an acute general surgical on call team. It can be a difficult diagnosis at times, particularly in sexually active young women, in whom it is often surgically challenging. This case is of a relatively straightforward diagnosis, taken for laparoscopic appendicectomy that resulted in performing an open right hemicolectomy for a necrotic, intussuscepted appendix. Histology ultimately revealed the cause of intussusception and resultant infarction of the appendix to be endometriosis. 2015 BMJ Publishing Group Ltd.

  10. Retrograde Jejuno‑gastric Intussusception

    African Journals Online (AJOL)

    Bowel sounds were normal. Abdominal X‑ray showed dilated stomach with dilated small bowel loops ... This was reduced and fixed to the abdominal wall and transverse mesocolon. It should be ... reduction of intussusception, but it is contraindicated when signs of peritoneal irritation are present.[9] Due to a limited view on ...

  11. [Gastroduodenal intussusception causing gastric retention.

    DEFF Research Database (Denmark)

    Alamili, M.; Berg, J.O.; Lindstrom, C.

    2008-01-01

    A case of gastroduodenal intussusception caused by a duodenal lipoma is presented. The condition was characterized by severe upper gastrointestinal retention, epigastric pain and weight loss. The mass was diagnosed by CT scan. The diagnosis was confirmed by operation. The patient was treated...

  12. Current radiological management of intussusception in children

    International Nuclear Information System (INIS)

    Ko, Hyun Soo; Schenk, Jens P.; Troeger, Jochen; Rohrschneider, Wiltrud K.

    2007-01-01

    Intussusception is the most common abdominal emergency situation in infants and small children. There has been great progress in diagnostic and therapeutic management of intussusception. Ultrasound (US) has been shown to be the first-choice imaging technique in diagnosing intussusception for reasons of high accuracy, simultaneous exclusion of differential diagnoses, and disclosure of additional pathologies. Controversial opinions exist worldwide concerning the nonoperative treatment of intussusception in infants and children. Pneumatic reduction under fluoroscopic guidance and hydrostatic reduction under US monitoring are the preferred techniques. The aim should be a success rate of at least 90% in idiopathic intussusception. This review summarizes different types of intussusception and outlines diagnostic aspects as well as several treatment concepts. (orig.)

  13. Management for intussusception in children.

    Science.gov (United States)

    Gluckman, Steven; Karpelowsky, Jonathan; Webster, Angela C; McGee, Richard G

    2017-06-01

    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 medium, imaging modality, pharmacological adjuvant, and protocol for delayed repeat enema, and on the best approach for surgical management for intussusception in children. To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children. We searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library; Ovid MEDLINE (1950 to September 2016); Ovid Embase (1974 to September 2016); Science Citation Index Expanded (via Web of Science) (1900 to September 2016); and BIOSIS Previews (1969 to September 2016).We examined the reference lists of all eligible trials to identify additional studies. To locate unpublished studies, we contacted content experts, searched the World Health Organization International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (September 2016), and explored proceedings from meetings of the British Association of Paedatric Surgeons (BAPS), the American Soceity of Pediatric Surgery, and the World Congress of Pediatric Surgery. We included all randomised controlled trials comparing contrast media, imaging modalities, pharmacological adjuvants, protocols for delayed repeat enema, and/or surgical approaches for the management of intussusception in children. We applied no language, publication date, or publication status restrictions. Two review authors independently conducted study selection and data extraction and assessed risk of bias using a standardised form. We resolved disagreements by consensus with a third review author when necessary. We reported

  14. Prolapsed ileocolic intussusception | Ibrahim | Annals of Pediatric ...

    African Journals Online (AJOL)

    Purpose This study aimed at presentingour experience with cases of prolapsed intussusception and discussing the line of treatment and the morbidity and mortality. Patients and methods Nine infants aged from 5 to 10 months were diagnosed as prolapsed intussusceptions by clinical examination. All of them were treated ...

  15. Ileoileal Intussusception Secondary to an Ileal Fibroma

    Directory of Open Access Journals (Sweden)

    Haritha Chelimilla

    2012-11-01

    Full Text Available Intussusception is defined as the telescoping of a segment of the gastrointestinal tract (intussusceptum into an immediately adjacent distal bowel (intussuscipiens. Intussusception is a relatively rare cause of intestinal obstruction in adults. Unlike in children, a lead point is present in 90% of adult cases. The most common causes of small bowel intussusception are benign, usually hamartomas, lipomas, inflammatory polyps, adenomas and leiomyomas, in contrast to the large intestine where malignant tumors, usually adenocarcinomas, are more common. The clinical presentation of adult intussusception is non-specific with variable manifestations, predominantly those of intestinal obstruction, often making the diagnosis a challenge. The onset of symptoms may be acute, intermittent or chronic. We present a rare case of an ileal fibroma presenting with intussusception. A 43-year-old woman presented to our outpatient clinic with a history of recurrent abdominal pain. The clinical presentation and CT scan findings led to the diagnosis of ileoileal intussusception. Subsequently she underwent laparotomy which revealed an ileal fibroma as the lead point of the intussusception. Surgical exploration remains essential for diagnosis and treatment since in the majority of cases a pathologic lead point is identified. Ileal fibroma is an uncommon benign neoplasm of the small bowel and must be considered in the differential diagnosis for small bowel intussusception.

  16. Adult Intussusception Secondary to Inflammatory Polyps

    Directory of Open Access Journals (Sweden)

    M. Faisal Jabar

    2005-01-01

    Full Text Available Adult intussusception is a rare entity that may present in the acute and subacute setting principally related to the degree of bowel obstruction. Preoperative diagnosis of this condition may be difficult. The intussusception is usually due to a definable intraluminal lesion, most probably neoplasia, unlike intussusception in children. We present the cases of two adult male patients with intussusception. The first presented with acute small-bowel obstruction secondary to a retrograde ileojejunal intussusception with a pseudopolyp as the lead point. This was possibly due to a retrograde ball-valve effect. The intussuscepting segment was resected. The second patient presented with unexplained chronic diarrhoea and an intussusception occurring within the caecum, as demonstrated at colonoscopy, with a terminal ileal pedunculated fibroid polyp as the lead point. A limited right hemicolectomy was performed. Both patients recovered uneventfully and have remained well. A brief literature review of adult intussusception complements the case reports, with an emphasis on the pathogenesis of inflammatory polyps and recommended surgical management.

  17. Causes and CT findings of adult intussusception

    International Nuclear Information System (INIS)

    Chun, Kyung Ah; Byun, Jae Young; Lee, Jae Mun; Ha, Hyun Kwon; Kim, Hyun; Park, Young Ha; Kim, II Sun; Kim, Jong Woo; Bahk, Yong Whee; Shinn, Kyung Sub

    1993-01-01

    Adult intussusception is a rare condition, unlike in children. There is an identifiable bowel lesion as a leading point in most of cases. Retrospectively we reviewed 22 patients with adult intussusception, and analyzed CT scans of 13 patients during the last 5 years. Twenty of the 22 patients had various causes of intussusception and 7 patients were associated with primary malignancy, 5 patients with benign tumor, and 4 patients with adhesive band. CT scans of 13 cases all showed characteristic target appearance or sausage-like soft tissue mass within the bowel, suggesting intussusception. In eleven of the 13 patients(84.6%) an intussuscepting mass was identified on CT scan as the lead point. Specific diagnosis for the cause of intussusception could be made by CT in four of 13 cases (three lipomas and one mucocele). In conclusion, CT is useful not only for the diagnosis but also for the evaluation of the leading causes of intussusception. Especially, CT could determined the exact causes of intussusception in cases of lipoma and mucocele

  18. Multiple Intussusceptions Associated with Polycythemia in an ...

    African Journals Online (AJOL)

    Intussusceptions are generally associated with mechanical lead points or localized inflammation that function as foci for intestinal telescoping. We present the case of a patient whose abuse of anabolic steroids resulted in the development of multiple simultaneous intussusceptions. Our patient had no additional identifiable ...

  19. Recurrent intussusception in children and infants

    Directory of Open Access Journals (Sweden)

    Amine Ksia

    2013-01-01

    Full Text Available Background: Recurrent intussusceptions in child and infants are problematic and there are controversies about its management. The aim of this study is to determine the details of the clinical diagnosis of recurrent intussusception and to determine the aetiology of recurrent intussusceptions. Patients and Methods: It′s a retrospective study of 28 cases of recurrent intussusception treated in the paediatric surgery department of Monastir (Tunisia between January 1998 and December 2011. Results: During the study period, 505 patients were treated for 544 episodes of intussusception; there were 39 episodes of recurrent intussusceptions in 28 patients; the rate of patients with recurrence was 5.5%. With comparison to the initial episode, clinical features were similar to the recurrent episode, except bloody stool that was absent in the recurrent group (P = 0,016. Only one patient had a pathologic local point. Conclusion: In recurrent intussusception, patients are less symptomatic and consult quickly. Systematic surgical exploration is not needed as recurrent intussusceptions are easily reduced by air or hydrostatic enema and are not associated with a high rate of pathologic leading points.

  20. Radiology residents' experience with intussusception reduction.

    Science.gov (United States)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L; Li, Chin-Shang

    2011-06-01

    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model.

  1. Anaesthetic management of intussusception in pregnancy | Nwasor ...

    African Journals Online (AJOL)

    Teamwork will win and effective communication between obstetrician, surgeon, anesthesiologist and neonatologist is obligatory. Good knowledge of the simplest and fastest anaesthetic techniques available will ensure a fruitful outcome. Keywords: anaesthesia, intussusception, obstetric patients. Annals of African Medicine ...

  2. Diagnosis and Treatment of Intussusception in Children

    Directory of Open Access Journals (Sweden)

    O.V. Spakhi

    2016-08-01

    Full Text Available Intussusception is the most common form of acquired gastrointestinal obstruction in children. The aim is to study the features of clinical course and treatment strategy for intussusception in children and to analyze limitations of diagnostic, clinical and special research methods. Materials and methods of the study. The analysis of treatment outcomes has been carried out in 272 children in pediatric surgery clinic from 2004 to 2015. We have developed the objective criteria for evaluation of intussusception stages that correlate with the degree of endotoxemia, changes in respiratory function and circulation, the disorders of gut motility, as well as ultrasound of the abdominal organs. Results and discussion. Patients with intussusception stage I (233 children had no signs of endotoxemia or they were non-significant. In 10 children we performed surgery, in 4 cases — laporoscopically. Of the 32 patients with stage II, in 8 cases the intussusception was straightened conservatively on the first try. We don’t make a second attempt in children with intussusception stage II. Surgical straightening was perfomed in 24 patients. Intussusception stage III in children (7 patients had signs of third degree endotoxemia. All patients of the third stage of intussusception underwent median laparotomy. In 5 cases we have detected intussusceptum necrosis, and these children were made bowel resection followed by the imposition of final ileostomy and intubation of the small intestine. In the rest (2 of patients, we managed to straighten the intussusceptum, and the gut was recognized as vital. Imposing primary anastomosis after the bowel resection in peritonitis we consider unacceptable. Conclusions. 1. Comprehensive survey of children using laboratory and instrumental methods became the basis for the allocation of 3 stages of intussusception, which correlated with the degree of endotoxemia and impaired bowel functions: stage I — compensated; stage II

  3. Intussusception in dogs and cats: A review of 36 cases

    OpenAIRE

    Levitt, Lyndell; Bauer, Michael S.

    1992-01-01

    Intussusception is recognized as a common cause of bowel obstruction in small animals. This study documents the clinical and surgical findings in nine cats and 27 dogs diagnosed as having intussusception. The main purposes of the study were to define the predisposing causes and clinical signs of intussusception and to evaluate various surgical techniques commonly employed in its treatment. No common predisposing cause could be established. Diagnosis of intussusception was based most often on ...

  4. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    Intussusception is a known complication of Meckel's diverticulum. However, intrauterine intussusception secondary to Meckel's diverticulum has unknown incidence. Our case describes the medical and surgical management of a newborn with intrauterine intussusception of a Meckel's diverticulum as a cause of the vascular ...

  5. Pediatric radiology fellows' experience with intussusception reduction

    International Nuclear Information System (INIS)

    Stein-Wexler, Rebecca; Bateni, Cyrus; Wootton-Gorges, Sandra L.; Li, Chin-Shang

    2011-01-01

    Intussusception reduction allows young children to avoid surgery. However, graduating residents have had relatively little training in intussusception reduction and, for the most part, consider themselves ill-prepared to perform this procedure. The goal of this study was to assess the extent of training in intussusception reduction during one year of a pediatric radiology fellowship and to determine whether graduating fellows consider themselves adequately trained in this technique. Pediatric radiology fellows were surveyed during June 2010 and asked to characterize their fellowship, to indicate the number of intussusception reductions performed (both the total number and those performed with faculty oversight but without active faculty involvement), and to assess the adequacy of their training. There were 31 responses, representing almost 1/3 of current fellows. Pediatric radiology fellows perform on average 6.9 reductions, 3.8 of which are with faculty oversight but without active faculty involvement. Ninety percent consider themselves well-trained in the technique, whereas 10% are uncertain (none consider their training inadequate). Almost all pediatric radiology fellows consider their training in intussusception reduction to be adequate. (orig.)

  6. Endometrioid Adenocarcinoma of Caecum Causing Intussusception

    Directory of Open Access Journals (Sweden)

    Rashmi Verma

    2013-01-01

    Full Text Available Malignant transformation of endometriosis is rare and is usually seen in ovarian endometriosis. The colon and rectum are the most common sites for extragonadal endometriosis, and although serosal involvement is commonly seen, mucosal involvement is rare. Malignant transformation of endometriosis is a rare but a well-known complication of endometriosis. We report an unusual presentation of endometrioid adenocarcinoma with lymph node metastasis, arising from endometriosis in the caecal wall and causing ileocaecal intussusception. The patient presented with sudden onset of abdominal pain with features suggestive of acute appendicitis. Diagnostic laparoscopy revealed an ileocaecal intussusception. Conversion to open surgery confirmed a caecal mass causing ileocaecal intussusception, and a radical right hemicolectomy was performed. Histology revealed endometrioid adenocarcinoma arising in a focus of endometriosis in the muscularis propria and involving the mucosa, with one regional metastatic lymph node.

  7. Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

    Directory of Open Access Journals (Sweden)

    Hiroaki Shiba

    2009-11-01

    Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

  8. Adult Intussusception Caused by Heterotopic Pancreas

    Directory of Open Access Journals (Sweden)

    Va-Kei Kok

    2007-05-01

    Full Text Available Heterotopic pancreas causing small bowel intussusception is rare. We report the case of a 24-year-old woman who presented with intermittent episodes of abdominal cramping and pain that had persisted for 10 days. A target-shaped lesion consisting of multiple concentric rings was found on the left side on contrast-enhanced computed tomography. Surgical intervention demonstrated jejunal intussusception caused by a jejunal heterotopic pancreas. Microscopically, several nesidioblastoses of pancreas were identified. Although very rare, small intestinal pancreatic rests may cause subacute bowel obstruction.

  9. Intestinal schistosomiasis associated with intussusception: a case ...

    African Journals Online (AJOL)

    Abstract: We report a case of intestinal schistosomiasis associated with iliocaecal intussusception resulting from obstructions of the terminal part of the ileum by schistosome egg-induced fibrosis. A 7- year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound ...

  10. Gastrointestinal stromal tumour presenting as gastroduodenal intussusception.

    LENUS (Irish Health Repository)

    Wilson, Mark H

    2012-08-01

    Gastroduodenal intussusception secondary to gastrointestinal stromal tumour is a very rare cause for intestinal obstruction. The diagnosis of this condition can be challenging, as symptoms are often non-specific and intermittent. This article reports a case where the diagnosis was made preoperatively with abdominal imaging and was treated by a combination of endoscopic reduction and laparoscopic resection.

  11. the association of midgut malrotation with intussusception

    African Journals Online (AJOL)

    CHIRDAN

    Mini Review. Association of midgut malrotation with intussusception. L. B Chirdan and A. F Uba. Paediatric surgery unit. Department of surgery Jos University .... midline. There was no identifiable pathology at the lead point in any of them. This would strongly support the opinion of Breckon and Hadley that malrotation.

  12. Intussusception in Pregnancy - A rarely considered diagnosis ...

    African Journals Online (AJOL)

    The objective of this paper is to report a case of intussusception in a pregnant woman and to review the literature on the subject with a view to highlighting the peculiarities of this condition. The case file of a 26 year old Gravida 3, Para 0+2 lady who had appendectomy 5 years earlier and now presented at 33 weeks of ...

  13. Intestinal schistosomiasis associated with intussusception: a case ...

    African Journals Online (AJOL)

    A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of ...

  14. in diagnosis of secondary intussusception in children

    African Journals Online (AJOL)

    Ahmed Abougabal

    2014-12-02

    Dec 2, 2014 ... the most common cause of acute bowel obstruction and pain in infants. This leads to venous congestion and bowel wall edema. If intussusception is not diagnosed and treated adequately, reduced arterial blood supply, bowel infarction and perforation may follow, causing peritonitis and may even.

  15. in diagnosis of secondary intussusception in children

    African Journals Online (AJOL)

    Ahmed Abougabal

    2014-12-02

    Dec 2, 2014 ... lead points are uncommon. Lymphoma, polyps, Meckel's diverticulum and hematoma are most common identified lead points in children. Aim of the work: To assess the role of multidetector computed tomographic imaging in the diagnosis of secondary intussusception with pathological leading points in ...

  16. Intestinal intussusception due to concurrent infections with ...

    African Journals Online (AJOL)

    The rat was anorexic and depressed with rough hair coat, and died before the commencement of the experiment. Grossly, the intussusception was 7 cm in length and 27 cm caudal to the stomach and 81cm to the ileo-caecal junction. The affected part of the small intestine was moderately distended with worms and the ...

  17. Intussusception and volvulus secondary to jejunal adenocarcinoma ...

    African Journals Online (AJOL)

    ... of suspicion of malignancy in patients who present with the usual features of chronic anemia, weight loss and loss of appetite with an intra-abdominal mass. The presentation of acute intestinal obstruction, with mesenteric vein thrombosis probably due to intussusception or volvulus should not however lower the suspicion.

  18. Sonographycally guided hydrostatic reduction of childhood intussusception

    International Nuclear Information System (INIS)

    Vidmar, D.; Visnar Perovic, A.

    2004-01-01

    Background. Intussusception is the most common cause of bowel obstruction in children under two years of age. The proximal part of the bowel and its mesentery (the intussusceptum) enter within that part immediately beneath it (the intussuscipiens). Being pulled by peristalsis the mesenterial vessels get compressed which result in ishaemia of the bowel wall. Most intussusceptions are ileocolic. The diagnosis can be confirmed by a contrast enema or ultrasound. Sonography demonstrates a so-called ''target-within-a-target'' pattern (in cross-section) with thickened edematous bowel wall with or without vascularisation and prestenotic dilatation with increased peristalsis. Therapeutic reduction can be attempted by a contrast enema (following diagnostic procedure) or by air, both under fluoroscopic monitoring, or by normal saline under sonographic guidance. Patients and methods. We detected sonographically intussusception in three girls of 15, 16 and 18 months having typical clinical signs. We continued with hydrostatic reduction under the sonographic guidance. The reduction was attempted with a saline enema on body-temperature, introduced by the equipment for contrast enema. The bottle of normal saline was hung up 1 m over the examination desk. We needed few liters of saline to replace lost liquids due to the incomplete occlusion of rectum. Meanwhile we monitored the moving of the intussusceptum back into the proximal direction. Criteria for a succesful reduction were the disappearance of the intussusceptum and the passage of fluid through the ileocecal valve. Results. Success was proven in all three girls. No complications occured and the pain relieved immediately after the procedure. There were no signs of intussusception on sonography after 2 and 12 hours. We saw a slightly edematous wall of ileocecal valve and terminal ileum. Due to their exellent clinical conditions they were discharged from hospital after a second sonography. Conclusions. Sonographically guided

  19. Transient small-bowel intussusception in children on CT

    International Nuclear Information System (INIS)

    Strouse, Peter J.; DiPietro, Michael A.; Saez, Fermin

    2003-01-01

    To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a characteristic layered appearance and/or continuity with adjacent mesenteric fat. Ileocolic intussusceptions and intussusceptions related to feeding tubes were excluded. Imaging studies and medical records were reviewed. Twenty-five pediatric patients (16 boys, 9 girls; mean age 11.2 years) were identified with small-bowel intussusception on CT. No patient had a persistent intussusception requiring surgery. Fourteen had limited immediate repeat CT images as part of the same examination, ten of which demonstrated resolution of the CT abnormality. Follow-up CT [n=13 (6 within 24 h)], ultrasound (n=3), small-bowel follow-through (n=4) and surgery (n=3) showed no intussusception. In four patients with persistent symptoms, underlying pathology was identified requiring treatment (giardiasis, 2; small-bowel inflammation/strictures, 1; abscess and partial small-bowel obstruction after perforated appendicitis, 1). In 21 other patients, direct correlation of symptoms to CT abnormality was absent or questionable, no treatment was required, and there was no clinical or imaging evidence of persistence or recurrence. Most small-bowel intussusceptions identified in children by CT are transient and of no clinical significance. (orig.)

  20. Spontaneous reduction of intussusception: clinical spectrum, management and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kornecki, A.; Daneman, A.; Navarro, O.; Connolly, B.; Manson, D.; Alton, D.J. [Toronto Univ., ON (Canada); Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada)

    2000-01-01

    Background. To analyze the spectrum of clinical features, management and outcome of children with documented spontaneous reduction of intussusception (SROI). Materials and methods. Review of records of 50 children (33 boys, 17 girls; age range 11 days-15 years; mean age 4 years) with documented SROI, in whom intussusception was initially diagnosed by sonography (US) in 44, air enema in 2, and computed tomography in 4, in the 6-year period 1992-1998. Results. Symptoms suggestive of intussusception were present in 21 (3 of whom had Henoch-Schoenlein purpura and 4 had previous ileocolic intussusception reduced by air enema). Intussusception was an incidental finding in the other 29, in 28 of whom the finding was in the small bowel. Intussusception was limited to the small bowel in 43 and was ileocolic in 7. SROI was usually documented on US. Laparotomy performed in only 4 showed no evidence of intussusception or pathologic lead point. Outcome in all patients was favorable. Conclusions. SROI may present in symptomatic or asymptomatic children and occurs more commonly than previously reported. These intussusceptions are usually short-segment, small-bowel intussusceptions with no recognizable lead point. In asymptomatic patients, conservative observation is warranted. Intervention should be dictated by the clinical findings in symptomatic patients. (orig.)

  1. Deep sedation during pneumatic reduction of intussusception.

    Science.gov (United States)

    Ilivitzki, Anat; Shtark, Luda Glozman; Arish, Karin; Engel, Ahuva

    2012-05-01

    Pneumatic reduction of intussusception under fluoroscopic guidance is a routine procedure. The unsedated child may resist the procedure, which may lengthen its duration and increase the radiation dose. We use deep sedation during the procedure to overcome these difficulties. The purpose of this study was to summarize our experience with deep sedation during fluoroscopic reduction of intussusception and assess the added value and complication rate of deep sedation. All children with intussusception who underwent pneumatic reduction in our hospital between January 2004 and June 2011 were included in this retrospective study. Anesthetists sedated the children using propofol. The fluoroscopic studies, ultrasound (US) studies and the childrens' charts were reviewed. One hundred thirty-one attempted reductions were performed in 119 children, of which 121 (92%) were successful and 10 (8%) failed. Two perforations (1.5%) occurred during attempted reduction. Average fluoroscopic time was 1.5 minutes. No complication to sedation was recorded. Deep sedation with propofol did not add any complication to the pneumatic reduction. The fluoroscopic time was short. The success rate of reduction was high,raising the possibility that sedation is beneficial, possibly by smooth muscle relaxation.

  2. BARIUM REDUCTION OF INTUSSUSCEPTION IN INFANCY

    Science.gov (United States)

    Denenholz, Edward J.; Feher, George. S.

    1955-01-01

    Barium enema reduction was used as the initial routine treatment in 29 infants with intussusception. In 22 of them the intussusception was reduced by this means. In three of eight patients operated upon the intussusception was found to be reduced. Four of the remaining five patients had clinical or x-ray evidence of complications before reduction by barium enema was attempted. Twenty-one of the patients, all of whom were observed in private practice, were treated without admission to the hospital. After reduction, these patients were observed closely by the clinician. None of these patients showed clinical or x-ray signs of complications before reduction. Certain clinical and roentgen criteria must be satisfied before it can be concluded that reduction by barium enema is complete. If there are clinical signs of complications with x-ray evidence of small bowel obstruction, only a very cautious attempt at hydrostatic reduction should be made. As the time factor is generally a reliable clinical guide to reducibility, the late cases should be viewed with greater caution. Long duration of symptoms, however, is not per se a contraindication to an attempt at hydrostatic reduction. PMID:13230908

  3. Ultrasonographic diagnosis and surgical management of double intestinal intussusception in 3 dogs

    OpenAIRE

    Atray, Mandeep; Raghunath, Mulinti; Singh, Tarunbir; Saini, Narinder Singh

    2012-01-01

    The diagnosis and treatment of double intestinal intussusception in 3 pups with persistent vomiting, diarrhea, dehydration, anemia, leucocytosis, and electrolyte imbalance are described. Ultrasonography confirmed intussusception and laparotomy revealed double intussusceptions. Intussusceptions were corrected by manual reduction in 1 pup and intestinal resection and anastomosis in 2 pups. Two pups survived and 1 pup died on the 4th day after surgery.

  4. Ultrasonographic diagnosis and surgical management of double intestinal intussusception in 3 dogs.

    Science.gov (United States)

    Atray, Mandeep; Raghunath, Mulinti; Singh, Tarunbir; Saini, Narinder Singh

    2012-08-01

    The diagnosis and treatment of double intestinal intussusception in 3 pups with persistent vomiting, diarrhea, dehydration, anemia, leucocytosis, and electrolyte imbalance are described. Ultrasonography confirmed intussusception and laparotomy revealed double intussusceptions. Intussusceptions were corrected by manual reduction in 1 pup and intestinal resection and anastomosis in 2 pups. Two pups survived and 1 pup died on the 4th day after surgery.

  5. A case of compound intussusceptions in a Nigerian child – a rare ...

    African Journals Online (AJOL)

    Intussusception is the most common, non-congenital, cause of intestinal obstruction in infants. There are various patterns of intussusception seen in children with the most common being ileo-colic variety. Compound intussusception in which intussusception involves more than one non-adjacent segment is a rare finding in ...

  6. Pediatric intussusception in a Saudi Arabian tertiary hospital

    African Journals Online (AJOL)

    Karp, James E. Allen and Theodore C. Jewett, Jr. Intussusception: Evolution of Current Management. J Pediatric. Gastroenterol Nutr, Vol 6 No 5, 1987. 1 1. Ajao O G. Non-infantile intussusception J. Natl Med Assoc. 1979; 71: 65 -67. 12. Mackay A J . Mackellar A and Sprague P. lntussuseeption in. '\\ Children: A review of 91 ...

  7. Delayed presentation of intussusception in children–a surgical audit

    African Journals Online (AJOL)

    473–480. 2 Kaiser AD, Applegate KE, Ladd AP. Current success in the treatment of intussusception in children. Surgery 2007; 142:469–477. 3 Herwig K, Brenkert T, Losek JD. Enema-reduced intussusception management: is hospitalization ...

  8. Delayed presentation of intussusception in children–a surgical audit ...

    African Journals Online (AJOL)

    Background The preferred modality of treatment of intussusception is radiologic reduction; however, the situation is different in our setup, in which surgery is the only possible treatment modality to salvage patients. This study presents the management of patients of intussusception in our setup with delayed presentation, ...

  9. Small bowel intussusception in 2 adults caused by inflammatory polyps

    Directory of Open Access Journals (Sweden)

    André Carvalho, MD

    2017-12-01

    Full Text Available Inflammatory fibroid polyps are rare, benign pseudotumors of the gastrointestinal tract of unknown etiology, which may rarely present as bowel intussusception and obstruction. The authors describe the clinical, radiologic, and pathologic features of 2 patients with ileal inflammatory fibroid polyps presenting as small bowel intussusception.

  10. Adult intussusception due to intestinal tuberculosis: a rare entity ...

    African Journals Online (AJOL)

    Intussusception is a rare occurrence in adults in comparison with the children. A demonstrable aetiology is found in most cases of adult intussusception. Abdominal tuberculosis (TB) is common in developing countries especially in South Africa in the era of HIV/ AIDS, and many of them present with surgical abdomens ...

  11. Prolapsed intussusception in children: a report of 4 cases | Ngom ...

    African Journals Online (AJOL)

    Background: Prolapsed intussusception is defined the invagination of an intestinal segment into the adjacent segment to it, with exteriorization of the head intussusception through the anus. Patients and Methods: Four children were diagnosed in the Emergency Unit of “Hôpital Aristide Le Dantec” of Dakar. Results: The ...

  12. The second trial pneumatic reduction for idiopathic intussusception ...

    African Journals Online (AJOL)

    Purpose To study the therapeutic effect of the second trial pneumatic reduction on patients with idiopathic intussusception. Patients and methods A prospective study was carried out on patients with idiopathic intussusception presenting to our unit, between August 2009 and January 2010. We excluded patients older than 2 ...

  13. Colo-colic intussusception associated with pneumatosis cystoides intestinalis

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, O.; Daneman, A.; Alton, D.J. [Department of Diagnostic Imaging, Hospital for Sick Children and the University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada); Thorner, P. [The Division of Pathology, Hospital for Sick Children and the University of Toronto, Toronto (Canada)

    1998-07-01

    This paper describes pneumatosis cystoides intestinalis in association with colo-colic intussusception in a young teenager. The intussusception was easily reduced at barium enema. The recognition of the characteristic filling defects in the barium column facilitates a correct diagnosis. This association has only been reported previously in six adults. (orig.) With 2 figs., 9 refs.

  14. a case of compound intussusceptions in a nigerian child

    African Journals Online (AJOL)

    is a major contributor to morbidity and mortality in the treatment of intestinal obstruction. We report the first documented case of double compound intussusception in an. African child and reviewed relevant literature. Keywords: Antegrade and retrograde; Children; Compound; Intussusception. Annals of Ibadan Postgraduate ...

  15. Colo-colic intussusception associated with pneumatosis cystoides intestinalis

    International Nuclear Information System (INIS)

    Navarro, O.; Daneman, A.; Alton, D.J.; Thorner, P.

    1998-01-01

    This paper describes pneumatosis cystoides intestinalis in association with colo-colic intussusception in a young teenager. The intussusception was easily reduced at barium enema. The recognition of the characteristic filling defects in the barium column facilitates a correct diagnosis. This association has only been reported previously in six adults. (orig.)

  16. Chronic intussusception in children caused by Ascaris lumbricoides.

    Science.gov (United States)

    Nikolić, Harry; Palčevski, Goran; Saina, Giordano; Peršić, Mladen

    2011-05-01

    Chronic intussusception (CI) is defined as an intussusception lasting for 14 days or more. Because the clinical manifestations are non-specific, the diagnosis is usually delayed. Symptoms include intermittent abdominal pain, sometimes an abdominal mass is palpable and there is a marked weight loss. Diagnosis is based on typical features revealed by ultrasound or barium enema and CT investigations. Therapy is surgical with obligatory exclusion of possible underlying lesions. We report a case of a 3.5-year-old girl with chronic intussusception. Laboratory blood findings revealed sideropenic anemia and stools positive for Ascaris lumbricoides. Anti-parasitic therapy with mebendazole was repeatedly administered with early improvements but soon after symptoms relapsed. During surgery an ileocolic chronic intussusception extending to hepatic flexure was found. Postoperative control examinations proved complete healing. We suspected that Ascaris lumbricoides infestation was an etiologic factor for the development of chronic intussusception in the child.

  17. Intussusception. Part 1: A review of diagnostic approaches

    Energy Technology Data Exchange (ETDEWEB)

    Daneman, Alan; Navarro, Oscar [Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada)

    2003-02-01

    The vast majority of symptomatic intussusceptions in children arise in the ileum and are either ileocolic or ileoileocolic. The clinical diagnosis of these ''idiopathic'' intussusceptions may be difficult to make. Failure to make a prompt diagnosis and initiate appropriate treatment may lead to bowel ischemia, perforation, peritonitis, shock and even death. The clinician, therefore, may have to rely on imaging procedures to diagnose or exclude the presence of intussusception promptly and accurately. The imaging diagnosis of intussusception can be made with sonography or plain abdominal radiographs or by contrast (including air) enema examinations of the colon. This article highlights the current concepts and some controversial issues related to the imaging diagnosis of intussusception. (orig.)

  18. Ultrasonographic findings of intestinal intussusception in seven cats.

    Science.gov (United States)

    Patsikas, M N; Papazoglou, L G; Papaioannou, N G; Savvas, I; Kazakos, G M; Dessiris, A K

    2003-12-01

    The medical records of seven cats with intestinal intussusception that were diagnosed by abdominal ultrasonography and exploratory laparotomy were reviewed. In transverse ultrasonographic sections the intussusception appeared as a target-like mass consisting of one, two or more hyperechoic and hypoechoic concentric rings surrounding a C-shaped, circular or non-specific shaped hyperechoic centre. Part of the intestine representing the inner intussusceptum, located close to the hyperechoic centre and surrounded by concentric rings, was also detected. In longitudinal sections the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines in four cases and as an ovoid mass in three cases. In one case the ovoid mass had a 'kidney' configuration. Additional ultrasonographic findings associated with intestinal intussusception included an intestinal neoplasm in one cat. The results of the present study demonstrate that the ultrasonographic findings of intestinal intussusception in cats bear some similarities to those described in dogs and humans, are relatively consistent, and facilitate a specific diagnosis.

  19. Intussusception in children: not only surgical treatment

    Directory of Open Access Journals (Sweden)

    Anna Maria Caruso

    2017-02-01

    Full Text Available Introduction: Intussusception is the commonest cause of acute in­testinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery.Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed.Result: A total of 44 pediatric patients were included in the study. The most frequent symptoms observed were paroxysmal abdominal pain (100% of cases and vomiting (72%; only 29% of patients presented with the classic triad of symptoms (abdominal pain, palpable mass and blood stained stools. 28 patients (64% were managed conservatively with ultrasound hydrostatic reduction. 10 patients (23% required primary surgical intervention because of clinical conditions; 6 patients (14% were operated after failure of conservative approach. The total percentage of operated patients was 36%, with lead points identified in 12 cases.Conclusion: Our data confirm that hydrostatic reduction is a simple, real time procedure, free of radiations, non invasive and safe. Age had no impact on the reducibility whereas bloody stool, a prolonged duration of symptoms and the presence of lead point were risk factors of failure.

  20. Intussusception in dogs and cats: A review of 36 cases

    Science.gov (United States)

    Levitt, Lyndell; Bauer, Michael S.

    1992-01-01

    Intussusception is recognized as a common cause of bowel obstruction in small animals. This study documents the clinical and surgical findings in nine cats and 27 dogs diagnosed as having intussusception. The main purposes of the study were to define the predisposing causes and clinical signs of intussusception and to evaluate various surgical techniques commonly employed in its treatment. No common predisposing cause could be established. Diagnosis of intussusception was based most often on clinical signs of bowel obstruction in association with the palpable abdominal mass. The majority of the intussusceptions involved the enterocolic junction. Formation of adhesions was more frequent in cats. Surgical treatments included simple reduction, manual reduction with plication, intestinal resection/anastomosis, and intestinal resection/anastamosis with plication. There was no statistically significant difference (p>0.05) in the recurrence rate of the intussusceptions when the various surgical techniques were compared. Recurrence of an intussusception was not related to either the bowel segment involved or whether a simple reduction, bowel resection, or intestinal plication was performed at the initial surgery. PMID:17424091

  1. Pylorogastric intussusception in a Chihuahua puppy. A case report.

    Science.gov (United States)

    Lideo, L; Mutinelli, F; Milan, R

    2010-12-01

    A three-month-old Chihuahua dog was presented with acute abdominal pain, vomiting and cardiovascular shock. Abdominal ultrasound (US) and iodated contrast gastrogram revealed suspected pylorogastric intussusception. Because of the poor prognosis the dog was euthanatized. Diagnosis of pylorogastric intussusception was confirmed at necropsy. Parasitological, virological, serological and histological examinations were also performed. This report documents the sixth case of pylorogastric (i.e. duodenogastric, gastrogastric) intussusception in the veterinary medical literature and it is the first report on a puppy dog in which US and radiographic diagnosis were confirmed post mortem.

  2. Jejunojejunal Intussusception Induced by Lipomatous Polyp of Jejunum

    Directory of Open Access Journals (Sweden)

    Jayant Kumar Biswal

    2017-10-01

    Full Text Available Adult intussusception is rare unlike childhood variety where it is the leading cause of intestinal obstruction. Preoperative diagnosis is often difficult as the symptoms are nonspecific and so high index of suspicion is needed for early diagnosis by appropriate investigations. This is a case of 65-year-old man presented with acute intestinal obstruction whose laparotomy revealed a jejunojejunal intussusception secondary to a lipomatous lesion which was successfully treated with resection and primary anastomosis. When dealing with a case of chronic intermittent intestinal obstruction, intussusception must be kept in mind as one of the differential diagnosis.

  3. Adult ileocolic intussusception secondary to ileocaecal valve polyp.

    LENUS (Irish Health Repository)

    Chugthai, Saqib Zeeshan

    2012-01-31

    Intussusception is relatively common in children, but it is a rare cause of abdominal pain and intestinal obstruction in adults. The aetiology, clinical presentation and management of this condition differs in adults and children. Preoperative clinical diagnosis is usually difficult due to the non-specific and intermittent nature of the symptoms. Ultrasound and computed tomography can be helpful in establishing the diagnosis. We present a case of adult ileocolic intussusception with classical radiological signs and operative findings. In adults the diagnosis of intussusception should be considered in a case of intermittent abdominal pain, especially with clinical signs of intermittent bowel obstruction.

  4. [Torsion of the vermiform appendix associated with intussusception].

    Science.gov (United States)

    Baeza-Herrera, Carlos; García-Cabello, Luis Manuel; León-Cruz, Alberto; Martínez-Rivera, María de Lourdes

    2006-01-01

    Vermiform appendix torsion is a rare condition, with only 25 cases recorded in the international literature. Our patient is the first case associated with intussusception. A 2-month-old female infant suddenly developed severe abdominal pain due to ileoceal intussusception. During surgical exploration, a tight intussusception was reduced. Three days later, a new laparotomy was required and we found torsion and perforation of the vermiform appendix. The patient underwent appendectomy, but there was dehiscence of the appendiceal stump and cecal perforation requiring a new surgical exploration. The patient had an uneventful recovery.

  5. Ultrasound guided reduction of childhood intussusception

    International Nuclear Information System (INIS)

    Yoon, Chong Hyun; Kim, Han Suk

    1986-01-01

    Following on from diagnosis using ultrasound, hydrostatic reduction using saline enema under ultrasound guidance was tried in 20 cases of childhood intussusception. The conclusions were as follows: 1. Success rates of saline enema under ultrasound guidance during a first-8 month period (P1) and a second-10 month period (P2) were 55.6% (5/9) and 54.5% (6/11) respectively. Average success rate was 55% (11/20). 2. During the periods of P1 and P2, no case was reduced by barium enema in 6 cases of failed reduction with saline enema. 3. During the period of P2, 5 cases of successful reduction with saline enema were confirmed by clinical follow-up without barium enema. 4. During the periods of P1 and P2, 9 cases of failed reduction with saline enema were operated, resulting in 6 cases of segmental resection and 3 cases of manual reduction. 5. The obvious advantages of this method are: 1. No radiation hazard. 2. No fear of barium peritonitis. 3. Detection of leading point. 6. With above results, this method could completely replace barium enema. And ultrasonography should be the initial study in the evaluation of intussusception in children and then if necessary, saline enema under ultrasound guidance should be done.

  6. Evaluating Pediatric Intussusception Using 24-hour Ultrasound

    Directory of Open Access Journals (Sweden)

    Yi-Jung Chang

    2013-08-01

    Conclusion: Radiographic imaging at night results in higher radiation exposure and negative enema findings. Twenty-four-hour ultrasound availability would decrease the radiation exposure and unnecessary enemas for intussusceptions suspected clinically.

  7. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    Meckel's diverticulum: the lead point of intrauterine intussusception with subsequent intestinal atresia in a newborn. Viet H. Le, Paul A. Perry, Allyson L. Hale, Robert L. Gates, John C. Chandler ...

  8. Recurrent intussusception, coeliac disease and cholelithiasis: A unique combination

    Directory of Open Access Journals (Sweden)

    Sinha C

    2007-01-01

    Full Text Available Authors report an 11-month-old female child, who presented with recurrent episodes of colicky abdominal pain and diarrhea. An abdominal ultrasound revealed small bowel intussusception. She was also noted to have a thick walled gall bladder and a solitary gallstone. Further investigations confirmed the diagnosis of coeliac disease. The combination of small bowel intussusception, coeliac disease and cholelithiasis is unique and has not been reported in the literature.

  9. Colorectal intussusception: an unusual gastrointestinal complication of hereditary angioedema.

    Science.gov (United States)

    Witschi, A; Krähenbühl, L; Frei, E; Saltzman, J; Späth, P J; Müller, U R

    1996-09-01

    A 21-year-old man with a history of hereditary angioedema presented with protracted abdominal pain which failed to respond to infusion of C1 inhibitor concentrate. Evaluation by CT scan revealed extensive colorectal intussusception requiring surgical intervention. Under replacement therapy with C1 inhibitor concentrate, both the operation under general anesthesia and the postoperative phase were uneventful. The intraoperative examination suggested initiation of intussusception by local mucosal edema in the transverse colon.

  10. Acute jejunogastric intussusception: a rare cause of abdominal pain.

    Science.gov (United States)

    O'Dell, K B; Gordon, R S; Victory, C

    1992-05-01

    We report the case of a 61-year-old man with a history of a Bilroth II procedure who presented to the emergency department after 12 hours of severe epigastric pain and one episode of coffee-ground emesis. Computed tomography and esophagogastroduodenoscopy revealed intussuscepted jejunum through a gastrojejunostomy that required emergency operative reduction. This case illustrates the rare complication of acute jejunogastric intussusception more than 20 years after a Bilroth II procedure.

  11. [Contribution of imaging in intestinal intussusception in the adult. Apropos of a case of ileocolic intussusception secondary to cecal lipoma].

    Science.gov (United States)

    Farrokh, D; Saadaoui, H; Hainaux, B

    1996-01-01

    On the basis of a case of ileocolonic intussusception in a 35-year-old patient secondary to an obstructive lipoma of the caecum, the authors review the literature and discuss the clinical and radiological aspects of this disease. The diagnosis was established by CT scan and barium enema before surgery. Adult intussusception is a rare disease, which does not have any specific clinical features. Radiological imaging is the only complementary investigation which can suggest the diagnosis.

  12. Time requirement for barium reduction in intussusception

    International Nuclear Information System (INIS)

    Hwang, Hye Eun; Kim, Seung Ho; Kang, In Young; Park, Byoung Lan; Kim, Byoung Geun

    1988-01-01

    During the period between January 1985 and December 1987, barium reduction was performed in 146 cases of intussusception who were admitted to Kwangju Christian Hospital. The results were as follows: 1. Success rate to the symptom duration is relatively constant. 2. The success rate in infants with severe dehydration was 50% but it was gradually increased in infants with moderate dehydration and in infants with mild dehydration, 83.3% and 100% respectively. 3. The success rate of 12 cases in severely dehydrated infants with positive dissection sign was 16.7%. 4. The success rate of 15 cases in moderately dehydrated infants with positive dissection sign was 66.7%. 5. The average time requirement for barium reduction was 58.3 minutes. No serious complications were noted during barium reduction, except mild vomiting. 6. With above results, it is desirable that barium reduction should be performed according to the patient's physical status and radiologic findings.

  13. Prolapse of Intussusception through the Anus as a Result of Sigmoid Colon Cancer

    Directory of Open Access Journals (Sweden)

    Hiroki Ochiai

    2010-09-01

    Full Text Available Adult intussusception is rare and most often associated with cancer. We report a case of intussuscepted sigmoid colon into the rectum protruding from the anus of a 47-year-old woman. The cause of the intussusception was sigmoid colon cancer. We removed the intussuscepted part of the sigmoid colon as well as the rectum and regional lymph nodes. The patient recovered uneventfully and there has been no evidence of recurrence of the cancer.

  14. Non-Hodgkin's lymphoma revealed by an ilio-colic intussusception ...

    African Journals Online (AJOL)

    Intussusceptions are rare but well-known causes of the small bowel obstruction in adults and an underlying cause is present in the majority of cases. Lymphoma's involvement of the ileum is one of the rare causes of intussusception. CT is a sensitive examination that diagnoses intussusceptions and provides an excellent ...

  15. Mini-laparoscopic reduction of intussusception for children.

    Science.gov (United States)

    Lai, I R; Huang, M T; Lee, W J

    2000-06-01

    The success of mini-laparoscopic cholecystectomy and splenectomy has encouraged the application of this new technique in children with non-complicated intussusception. Here, we report on the use of this technique in two children, aged 21 and 24 months, respectively, who had failed saline enema reduction of ileocolic intussusception. Under a 2-mm videoscopic visualization, the intussuscepted bowel was identified and reduced with the assistance of a 2-mm working port placed at the right lower abdominal area and a 5- to 10-mm working port placed at the supraumbilical area. An intussuscepted lymph node at the ileocecal area, as the lead point, was removed at the time of the procedure in one child. Both patients experienced relief of symptoms the day after operation and resumed a regular diet on the first post-operative day. No recurrence or complications, including abscess and wound infection, occurred. These findings suggest that mini-laparoscopic reduction is a safe procedure for children with uncomplicated intussusception. Moreover, the procedure provides better cosmesis than conventional laparoscopic techniques.

  16. Successful Endoscopic Repair of Postoperative Ileocecal Intussusception in An Adult

    Directory of Open Access Journals (Sweden)

    Manabu Shiraishi

    2013-06-01

    Full Text Available Postoperative ileocecal intussusception is a rare complication in adult patients with abdominal aortic repair. A 63-year-old male patient with an abdominal aortic aneurysm was admitted to our hospital for abdominal aortic replacement. On the third postoperative day, he had nausea, vomiting, and distention. An abdominal x-ray showed air-fluid levels. His condition improved after 72 h of conservative treatment with long-tube suction for decompression. On the sixth postoperative day, he had acute abdominal pain. A computed tomography scan showed the typical intussusception picture. A diagnostic and therapeutic endoscopy were performed. An ileocecal intussusception 20 cm proximal to the ileocecal valve was found and endoscopically reduced. [Arch Clin Exp Surg 2013; 2(3.000: 204-206

  17. [Intussusception following renal transplantation in dogs (author's transl)].

    Science.gov (United States)

    Olsen, P R; Boserup, F; Mikkelsen, A M; Rorbech, U

    1977-01-01

    In a consecutive and non-selected study of 54 kidney transplanted dogs, 12 cases of intussusception of the small intestine developed in 8 dogs. The patogenesis is still unknown. It has been postulated that the time of the operation (4--7 hours) and the segmental termination of the post-operative atony in the intestine are essential factors in this fatal complication. The last 16 dogs in this material were peroperatively treated with antikolinergics (Mestinon NFN), which was continued until normal function of the intestine. In these dogs there were no evidence of intussusception. The value of this profylaxis is open to discussion and it is essential to solve the problem of intussusception through a "blind" and controlled trial.

  18. [Yersinia enterocolitica: a cause of acute intestinal intussusception].

    Science.gov (United States)

    Barthod, F; Gayet, P; Parlier, H; Turner, L; Barre, O; Farah, A; Patel, J C

    1996-04-20

    Yersinia enterocolitica infection is a rare cause of intestinal intussusception, especially in adults. We report here a case in a 29-year-old man and review the literature on diagnosis and therapy. A 29-year-old man presented with a 2-week history of diarrhea and weight loss. Ultrasonography revealed acute intestinal intussusception localized at the site of enlarged mesenteric nodes. At laparostomy, intestinal resection was not required. Histology examination of the mesenteric nodes showed follicular hyperplasia. Serology was positive for Yersinia enterocolitica. Outcome was favorable after treatment with tetracycline for 15 days. Yersinia enterocolitica are Gram negative bacilli that grow at low temperature. Food contamination is the most frequent source of infection in man, usually in children. Clinical manifestations include gastroenteritis or pseudoappendicular syndrome. Intestinal intussusception is rare. Operative reduction by taxis is generally sufficient. Histology examination of the lymph nodes excludes lymphoma. The diagnosis is confirmed by serology. A 10 to 15-day antibiotic regimen is needed.

  19. US features of transient small bowel intussusception in pediatric patients

    International Nuclear Information System (INIS)

    Kim, Ji Hye

    2004-01-01

    To describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation. During a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed. The clinical presentations included abdominal pain or irritability (n = 25), vomiting (n 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5 ± 0.3 cm) diameters and with thin (mean, 3.5 ± 1 mm) outer rims along the course of the small bowel. The mean length was 1.8 ± 0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n 2). All patients discharged with improved condition. Typical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration

  20. Juvenile polyposis syndrome presenting as intussusception in a ...

    African Journals Online (AJOL)

    We report a rare case of juvenile polyposis syndrome (JPS) in a 5 year old girl who was admitted into the emergency room on account of acute intestinal obstruction secondary to ileo-colic intussusception. Prior to the admission, she has had repeated blood transfusion in the referring hospital following anaemia due to long ...

  1. Routine surgical intervention for childhood intussusception in a ...

    African Journals Online (AJOL)

    and inflamed Peyer's patches were noted in 37 (52.1%), and polyp in 3 (4.2%). Manual ... Conclusion: Intussusception in our setting is characterized by late presentation, high rate of bowel resection, and ... des lacunes dans le temps pour le diagnostic, les installations spécialisées et les membres du personnel améliorer.

  2. Seasonality and surgical management of intussusception over 10 ...

    African Journals Online (AJOL)

    47.5%of patients had resection and primary anastomosis while 24.0% had manual reduction at laparotomy. Conclusion: Intussusception is one of the most common paediatric surgical emergencies at Harare Central Hospital. The age and sex of patients are the same as those found in literature. In contrast with previous data ...

  3. Acute intussusception in children seen at El Obeid Hospital, Western ...

    African Journals Online (AJOL)

    54.2% of cases had resection and anastomosis for bowel ischaemia, while in 45.8% manual reduction was done. The post-operative mortality was 16.7%. Conclusions: Childhood intussusception was common in male infants from rural areas in the dry season. Late presentation to the surgeon necessitated major operative ...

  4. Jejuno-jejunal intussusception secondary to smallbowel lipomatosis ...

    African Journals Online (AJOL)

    Intussusception is usually a disease of children aged between 6 months and 4 years, in which a part of a bowel telescopes into another part of the bowel. We report a case in a 60-year-old man who required resection and anastomosis. Although intussception is unusual in adults, awareness of the differences in symptoms ...

  5. Case Report - Intussusception caused by an inverted Meckel's ...

    African Journals Online (AJOL)

    The intra operative findings were distention of the small bowel and intussusception of ileus due to an inverted Meckel's diverticulum located 70 cm from the ileocecal valve. 30 cm ischemic loop was identified. A segmental small bowel resection and hand-sewn anastomosis was performed. Histopathology distinguished ...

  6. Endoscopic Diagnosis of Jejuno-Gastric Intussusception | Mwachiro ...

    African Journals Online (AJOL)

    Jejunogastric intussusception is a rare complication of gastric surgery that is potentially life threatening if it is not diagnosed early. This condition is a surgical emergency and is most commonly seen after gastro-jejunostomy. The authors report a case of an elderly female patient who presented with hematemesis and ...

  7. Pneumatic reduction of intussusception in children at Korle Bu ...

    African Journals Online (AJOL)

    Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great ...

  8. Adult intussusception: An unlikely diagnosis | Nicolaou | SA Journal ...

    African Journals Online (AJOL)

    ... and it allows prompt surgical management to avoid severe complications, particularly bowel ischaemia and necrosis. This case report describes the clinical and multimodality radiological findings of an ileocolic intussusception secondary to a mucosa-associated lymphoid tissue (MALT) lymphoma in a young adult patient.

  9. The second trial pneumatic reduction for idiopathic intussusception ...

    African Journals Online (AJOL)

    Annals of Pediatric Surgery 2012, 8:77–79. Keywords: intussusception, pneumatic reduction, radiation dose. aPediatric Surgery Unit and bDepartment of Diagnostic Radiology and Medical. Imaging, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Correspondence to Amr Abdelhamid AbouZeid, MD, Pediatric ...

  10. Chronic Ileocecal Intussusception Secondary to Non-Hodgkins ...

    African Journals Online (AJOL)

    Chronic intussusception is a distinct clinical entity which is unfortunately poorly recognized due to its atypical presentation. A 5½ year old female patient presented with a 5 month history of abdominal pain associated with occasional vomiting, anorexia and progressive weight loss. 5 days prior to admission she developed ...

  11. Hydrostatic reduction of intussusception with normal saline using the ...

    African Journals Online (AJOL)

    Hydrostatic reduction of intussusception with normal saline using the gravity aided method in a Nigerian teaching hospital. M.A. Abdulsalam, B.O. Balogun, R.I. Osuoji, O.O. Olofinlade, O.M. Faboya, M.A. Bankole ...

  12. Intussusception after Laparoscopic Gastric Bypass Surgery: An Underrecognized Complication

    Directory of Open Access Journals (Sweden)

    Smit Singla

    2012-01-01

    Full Text Available Introduction. Intussusception after bariatric surgery is an uncommon complication that is now being frequently reported. Most people consider dysmotility to be the causative mechanism in the absence of obvious etiology. Material and Methods. A worldwide search identified literature describing intussusception after bariatric surgery. We also included our own patients and analyzed information regarding demographic profile, risk factors, presentation, diagnosis, and post treatment course. Results. Seventy one patients were identified between 1991 and 2011. Majority of the affected patients were females (=70, 98.6%; median time to presentation after gastric bypass surgery was 36 months. Most patients presented with abdominal pain, nausea and vomiting, but without obvious peritonitis. Sixty eight patients (96% required surgery; 48 (70.6% underwent revision of anastomosis, 16 (23.5% had reduction without resection, while 4 patients (5.9% had plication only. Amongst these, most patients (=51, 75% were found to have retrograde intussusception. Post-operatively, 9 patients presented with recurrence (range, 0.5–32 months. Five patients, who had earlier been treated without resection, eventually required revision of the anastomosis. There was no mortality noted. Conclusion. Intussusception after bariatric surgery is uncommon and its diagnosis is based on a combination of physicial, radiological and operative findings. An early surgical intervention reduces morbidity and prevents recurrence.

  13. An audit of paediatric intussusception radiological reduction at the ...

    African Journals Online (AJOL)

    An audit of paediatric intussusception radiological reduction at the Bloemfontein Academic Hospital Complex, Free State, South Africa. ... reduction outcomes were not comparable to international standards. The only statistically significant predictor of poor outcome of AIR was time delay before attempted reduction.

  14. Intussusception in children seen at Muhimbili National Hospital, Dar ...

    African Journals Online (AJOL)

    Objective: To review infants and children with intussusception and assess its magnitude of concern and any seasonal variation in our environment. Design: A retrospective study. Setting: Muhimbili National Hospital general paediatric and surgical wards from January 2000 to February 2004. Methodology: The charts of all ...

  15. Childhood intussusception at the Moi teaching and referral hospital ...

    African Journals Online (AJOL)

    Objective: To review the management of childhood intussusception at the Moi Teaching and Referral Hospital, Eldoret and identify factors that require attention for improved outcome. Design: A retrospective descriptive study covering the period January 2000 to December 2003. Setting: Moi Teaching and Referral Hospital, ...

  16. Intussusception caused by dried apricot: A case report

    Directory of Open Access Journals (Sweden)

    Yana Puckett

    2014-01-01

    CONCLUSION: Bezoars are an extremely rare cause of intussusception in adults. A high level of suspicion needs to exist in the presence of a history of eating dried fruit, history of gastric surgery, diabetes mellitus, and problems with mastication. Various treatment modalities exist to treat obstructions secondary to bezoars, including open reduction and removal of bezoar via enterotomy.

  17. Retrograde pylorogastric intussusception – Case report and review

    Directory of Open Access Journals (Sweden)

    Efrat Avinadav

    2016-07-01

    Full Text Available A case of gastric outlet obstruction in an infant due to retrograde intussusception of the pylorus into the stomach is presented. This anomaly is extremely rare, with almost no reports in the literature. The patient underwent formal Heineke-Mikulicz pyloroplasty with an uneventful recovery and resumed full enteral feeding.

  18. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    Retrograde jejunal intussusception is a rare disease. A 60‑year‑old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs‑en‑Y. On examination, there was a palpable wax‑like mass on the left‑hand side underneath the umbilicus. Computerized ...

  19. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    2015-11-02

    Nov 2, 2015 ... Retrograde jejunal intussusception is a rare disease. A 60-year-old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs-en-Y. On examination, there was a palpable wax-like mass on the left-hand side underneath the umbilicus.

  20. An audit of paediatric intussusception radiological reduction at the ...

    African Journals Online (AJOL)

    summarised in Table 1; 28 of the patients (80.0%) were 12 months old or younger. ... consecutive attempts of stepwise increased pneumatic pressure at. 80, 100 ... Table 2. Duration and type of symptoms among children diagnosed with intussusception (N=35) n. %. Duration of symptoms (hours). 24 - 48. 5. 14.7.

  1. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature

    International Nuclear Information System (INIS)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng; Costacurta, Marco Antonio; Albertotti, Cesar Jose; Cerri, Giovanni Guido

    2000-01-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  2. Endoscopic treatment of a large colonic polyp as a cause of colocolonic intussusception in a child

    OpenAIRE

    Suksamanapun, Nutnicha; Uiprasertkul, Mongkol; Ruangtrakool, Ravit; Akaraviputh, Thawatchai

    2010-01-01

    Colocolonic intussusception is an uncommon cause of intestinal obstruction in children. The most common type is idiopathic ileocolic intussusception. However, pathologic lead points occur approximately in 5% of cases. In pediatric patients, Meckel’s diverticulum is the most common lead point, followed by polyps and duplication. We present a case of recurrent colocolonic intussusception which caused colonic obstruction in a 10-year-old boy. A barium enema revealed a large polypoid mass at the ...

  3. Intussusception caused by an inverted Meckel diverticulum: a rare cause of small bowel obstruction in adults

    Directory of Open Access Journals (Sweden)

    Mahdi Bouassida

    2011-12-01

    Full Text Available Adult intussusception due to Meckel�s diverticulum is an uncommon cause of intestinal obstruction. However, the surgeon should still be suspicious of this condition since the non specific symptoms and the rarity of it make a preoperative diagnosis uncertain. Considering the secondary nature of adult intussusception and the necessity of early surgical intervention to avoid morbidity and mortality, we report one case of intussusception due to Meckel�s diverticulum in an adult.

  4. Multiple Intussusceptions as Primary Manifestation of Peutz-Jeghers Syndrome: Report of a Case

    OpenAIRE

    Ahmad Amouzeshi; Mohammad-Reza Motie; Ali Najib Jalali

    2009-01-01

    Background: Peutz-Jeghers syndrome is a rare hereditary disorder characterized by hamartomatous polyps in the gastrointestinal tract and typical pigment lesions. It is a rare cause of multiple intussusceptions. Previous studies on Peutz-Jeghers syndrome reported only one case of multiple intussusceptions. We describe a case of appendiceal and multiple small intestine intussusceptions presenting as peritonitis in a patient with Peutz-Jeghers syndrome. Case Presentation:A 17-year-old girl prese...

  5. Adult jejunojejunal intussusception - a case report and review of the literature. Radiological findings

    International Nuclear Information System (INIS)

    Setubal, Roger; Souza, Ricardo Pires de; Endo, Erica; Kataoka, Kazumi; Soares, Aldemir Humberto

    1996-01-01

    The author report a case of jejunojejunal intussusception caused by an adenomatous polyp in an adult. The majority of intussusception's cases occur in children with less than 2 years of age, with only 5% to 15% of cases occurring in adults. In contrast to pediatrics group intussusception, which is idiopathic in 90% of cases, adult intussusception has a demonstrable cause in more than 90% of cases. The pre-operative diagnosis is made by the association between the clinical presentation and plain abdominal radiographs, barium study of small intestine, ultrasound and computed tomography, described and discussed in this paper. (author)

  6. Ileocolic intussusception secondary to gastrointestinal stromal tumor in a 61-year-old.

    Science.gov (United States)

    Gelabert, Christopher; Torradas, Jose; Nelson, Mathew

    2014-10-01

    Intussusception is a common emergency in patients age of 3 months to 5 years. In adults, the diagnosis is infrequent but must be considered in the clinical setting of abdominal pain and vomiting. We present a case of a 61-year-old woman presenting with epigastric abdominal pain and vomiting, diagnosed with intussusception secondary to gastrointestinal stromal tumor. Serial bedside ultrasound examinations uncovered the diagnosis of intussusception, confirmed by computed tomographic scan during a paroxysm of pain. Intussusception has a much higher predilection for neoplasms in adults, with a high morbidity and mortality, so early recognition is critical in improving patient outcomes.

  7. Presentation of GIST as jejuno-jejunal intussusception

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2018-03-01

    Full Text Available Gastrointestinal stromal tumours (GISTs are rare tumour. It comprises 0.2% of gastrointestinal tumours and only 0.04% of small intestinal tumours. Usually this tumour is found in people in their 60s.These tumours can be found anywhere in the gastrointestinal tract but most commonly found in the stomach (40–60%. Patients with GISTs usually have vague and nonspecific symptoms. We present a 17year-old with complain of abdominal pain, distension, and few episodes of vomiting. All laboratory investigations were normal. The ultrasonography (USG and computed tomography (CT were suggestive of jejuno-jejunal intussusception. The patient had emergency exploratory laparotomy with resection of the segment with five cm healthy margin, and end to end anastomosis. Patient was discharged after 4 days and remains well. This case report highlights the rarity of GISTs in the concern of age (17 year old, site (Jejunum as well as presentation (intussusception.

  8. Jejunogastric intussusception in a child: A case report

    Directory of Open Access Journals (Sweden)

    Nathan Smith

    2014-11-01

    Full Text Available Jejunogastric intussusception is a rare event following gastrointestinal reconstruction. We present a case report in which jejunogastric intussuception was diagnosed in a child four years after a gastrectomy with jejunogastric reconstruction for duodenal duplication. Prompt diagnosis and emergent resection of any non-viable bowel, and revision to a Roux-En-Y anastomosis with or without pexy of the Roux limb to the colon or Y-limb mesentery appear to be the appropriate treatment for this clinical entity.

  9. Multidrug resistant shigella flexneri infection simulating intestinal intussusception

    OpenAIRE

    Srirangaraj Sreenivasan; Arunava Kali; Jothimani Pradeep

    2016-01-01

    Shigella enteritis remains an important cause of mortality and morbidity in all age groups, in developing as well as developed countries. Owing to the emerging resistance to multiple antibiotics among Shigella spp., it has been recognized as a major global public health concern and warrants constant monitoring of its resistance pattern. We report a case of segmental ileitis caused by non.-ESBL producing multidrug resistant Shigella flexneri in an infant clinically mimicking intussusception, w...

  10. Perforated appendicitis: an underappreciated mimic of intussusception on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Schmitz, Matthew; Gawande, Rakhee; Vasanawala, Shreyas; Barth, Richard [Lucile Packard Children' s Hospital, Department of Radiology, Stanford University, Stanford, CA (United States)

    2014-05-15

    We encountered multiple cases in which the US appearance of ruptured appendicitis mimicked intussusception, resulting in diagnostic and therapeutic delay and multiple additional imaging studies. To explore the clinical and imaging discriminatory features between the conditions. Initial US images in six children (age 16 months to 8 years; 4 boys, 2 girls) were reviewed independently and by consensus by three pediatric radiologists. These findings were compared and correlated with the original reports and subsequent US, fluoroscopic, and CT images and reports. All initial US studies demonstrated a multiple-ring-like appearance (target sign, most apparent on transverse views) with diagnostic consensus supportive of intussusception. In three cases, US findings were somewhat discrepant with clinical concerns. Subsequently, four of the six children had contrast enemas; two were thought to have partial or complete intussusception reduction. Three had a repeat US examination, with recognition of the correct diagnosis. None of the US examinations demonstrated definite intralesional lymph nodes or mesenteric fat, but central echogenicity caused by debris/appendicolith was misinterpreted as fat. All showed perilesional hyperechogenicity that, in retrospect, represented inflamed fat ''walling off'' of the perforated appendix. There were four CTs, all of which demonstrated a double-ring appearance that correlated with the US target appearance, with inner and outer rings representing the dilated appendix and walled-off appendiceal rupture, respectively. All six children had surgical confirmation of perforated appendicitis. Contained perforated appendicitis can produce US findings closely mimicking intussusception. Clinical correlation and careful multiplanar evaluation should allow for sonographic suspicion of perforated appendicitis, which can be confirmed on CT if necessary. (orig.)

  11. Multidrug resistant shigella flexneri infection simulating intestinal intussusception

    Directory of Open Access Journals (Sweden)

    Srirangaraj Sreenivasan

    2016-01-01

    Full Text Available Shigella enteritis remains an important cause of mortality and morbidity in all age groups, in developing as well as developed countries. Owing to the emerging resistance to multiple antibiotics among Shigella spp., it has been recognized as a major global public health concern and warrants constant monitoring of its resistance pattern. We report a case of segmental ileitis caused by non.-ESBL producing multidrug resistant Shigella flexneri in an infant clinically mimicking intussusception, which was effectively treated by ceftriaxone.

  12. A child with colo-colonic intussusception due to a large colonic polyp

    African Journals Online (AJOL)

    Colo-colonic intussusception (CI) due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic ... We report a case of CI and review the literature, focusing on the diagnosis and treatment. Key words: Children, colo-colonic intussusception, colonic polyp, intestinal obstruction ...

  13. Jejunogastric intussusception after distal gastrectomy with Roux-en-Y reconstruction: A case report.

    Science.gov (United States)

    Kawano, Fumiaki; Tashiro, Kousei; Nakao, Hironobu; Fujii, Yoshirou; Ikeda, Takuto; Takeno, Shinsuke; Nakamura, Kunihide; Nanashima, Atsushi

    2018-01-01

    Jejunogastric intussusception is a rare complication after gastric operation. Intussusception after gastric operation occurs mostly at the gastrojejunal anastomosis site and Braun anastomosis site of Billroth II reconstruction, and at the Y anastomosis site of Roux-en-Y reconstruction. However, jejunogastric intussusception after distal gastrectomy with Roux-en-Y reconstruction is very rare. We report a surgical case of jejunogastric intussusception after distal gastrectomy for gastric cancer treatment. An 82-year-old woman underwent laparoscopic distal gastrectomy for early gastric cancer treatment. Reconstruction was performed using Roux-en-Y anastomosis. Oral intake was started on postoperative day 4, however vomiting and high-grade fever occurred on postoperative day 12, after which oral intake became difficult. Anastomotic stenosis of the gastrojejunostomy was suspected, and various examinations were performed. Gastroendoscopy and computed tomography revealed an elevated lesion with ring-like folds protruding through the anastomosis site into the remnant stomach. Reoperation was performed on postoperative day 28 after a diagnosis of jejunogastric intussusception was made. It failed to reduce the intussusception, so partial resection of the gastrojejunal anastomosis was performed and Roux-en-Y reconstruction was repeated. Reconstruction was conducted after taking into consideration the recurrence of intussusception. Jejunogastric intussusceptions after distal gastrectomy is a rare complication; however, when it occurs, early diagnosis and appropriate management are necessary. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Henoch’s disease complicated by intestinal intussusception in a 5-year-old child

    Directory of Open Access Journals (Sweden)

    R. G. Artamonov

    2015-01-01

    Full Text Available Abdominal syndrome accompanied by abdominal pains is common in children with Henoch’s disease. One of the rare complications of the syndrome may be bowel intussusception. The paper describes a case of Henoch’s disease complicated intestinal intussusception.

  15. Transient small-bowel intussusceptions in adults: significance of ultrasonographic detection

    Energy Technology Data Exchange (ETDEWEB)

    Maconi, G. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy)]. E-mail: giovanni.maconi@unimi.it; Radice, E. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Greco, S. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Bezzio, C. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Bianchi Porro, G. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy)

    2007-08-15

    Aim: To investigate the frequency, clinical significance, and outcome of small-bowel intussusceptions in adults detected using ultrasound in an outpatient setting. Patients and methods: In two different retrospective (January 2001 to April 2003) and prospective (May 2003 to June 2005) periods, 33 small-bowel intussusceptions were found in 32 patients (13 females; mean age: 38.1 years) with known or suspected intestinal disease. Patients underwent diagnostic work-up to assess any organic disease. Patients with self-limiting intussusception were submitted to clinical and ultrasonographic follow-up. Results: Of the 32 patients with small-bowel intussusception, 25 were identified in the prospective series of 4487 examinations (0.53%) and seven in the retrospective series of 5342 examinations (0.15%; p = 0.002). Four patients had persistent and 28 self-limiting intussusceptions. Self-limiting intussusceptions were idiopathic in 11 patients (39%) or associated with organic diseases in 17 (Crohn's disease in 11 patients, celiac disease in three, ulcerative colitis in one patient, and previous surgery for cancer in two). Self-limiting intussusceptions were asymptomatic in 25% of patients. Conclusion: Small-bowel intussusceptions in adults are not rare and are frequently self-limiting, idiopathic, or related to organic diseases, mainly Crohn's disease and coeliac disease.

  16. Duodenal intussusception secondary to web presenting as recurrent pancreatitis in a 7-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Tu, Long H. [University of Connecticut School of Medicine, Farmington, CT (United States); Kaweah Delta Healthcare District, Graduate Medical Education, Visalia, CA (United States); Villalona, Gustavo A. [Yale School of Medicine, Department of Surgery, Section of Pediatric Surgery, New Haven, CT (United States); SSM Health Cardinal Glennon Children' s Hospital, Department of Pediatric Surgery, St. Louis, MO (United States); Cowles, Robert A. [Yale School of Medicine, Department of Surgery, Section of Pediatric Surgery, New Haven, CT (United States); Silva, Cicero T. [Yale School of Medicine, Department of Diagnostic Imaging, Section of Pediatric Radiology, 333 Cedar St., P.O. Box 208042, New Haven, CT (United States)

    2016-03-15

    Duodenal intussusception is a rare entity in children, with 32 cases reported in the English literature to our knowledge. Most reported cases are associated with endoluminal tubes or polyps, and the presenting symptoms are chronic and nonspecific. We report a case of duodenal intussusception in a 7-year-old girl secondary to a duodenal web and review the imaging findings. (orig.)

  17. Intussusception of the appendix mimicking appendicitis during pregnancy: a case report.

    Science.gov (United States)

    Fylstra, Donald L; Toussaint, William N; Anis, Munazza

    2009-05-01

    Intussusception occurs when a segment of bowel and its associated mesentery telescopes into the lumen of the adjacent distal bowel. Appendiceal intussusception is a rare form of ileocoloc intussusception, is rarely diagnosed preoperatively, can mimic appendicitis and has not been previously reported during pregnancy. A 31-year-old gravid woman at 27 1/7 weeks' gestation presented with symptoms suggestive of acute appendicitis and was found at laparoscopy to have complete appendiceal intussusception. The list of causes of abdominal pain in pregnancy is very long, but the presence of right-sided abdominal tenderness with guarding and rebound are highly suggestive of acute appendicitis. Regardless of preoperative imaging, because the morbidity, and even mortality, from appendicitis is the morbidity of delay, early surgical intervention is recommended. This is a case of complete appendiceal intussusception mimicking acute appendicitis, but the treatment of both conditions is appendectomy.

  18. A rare association of intussusception and celiac disease in a child

    Directory of Open Access Journals (Sweden)

    Vanessa Pacini Inaba Fernandes

    Full Text Available ABSTRACT: CONTEXT: Intussusception is a common cause of acute intestinal obstruction in the pediatric population and it is normally idiopathic. Rare cases of chronic intussusception require investigation with greater attention. CASE REPORT: We present a clinical case of a three-year-old boy with aqueous diarrhea, abdominal distension, vomiting and weight loss over a two-month period. During the investigation, abdominal ultrasound showed imaging of intussusception. The intraoperative findings showed the intussusception had resolved spontaneously. In further investigation, it was found that the diarrhea was malabsorptive and, after the patient underwent upper gastrointestinal endoscopy, a diagnosis of celiac disease was made. After a gluten-free diet was introduced, the patient showed complete remission of symptoms and regained weight, and normal growth was reestablished. CONCLUSION: If the clinical presentation of intussusception is unusual, etiological investigation should be undertaken. In this case report, celiac disease was the underlying cause.

  19. Multiple Intestinal Intussusceptions as a Complication of Severe Hyperglycemia in a Patient with Diabetic Ketoacidosis

    Directory of Open Access Journals (Sweden)

    Pooja Raghavan

    2012-01-01

    Full Text Available Intussusception in adults is a rare phenomenon, occurring in approximately 1 in 30,000 hospital admissions annually. When it does occur, the majority of cases involve an organic lesion serving as a lead point for intussusception, such as tumors or postoperative adhesions. In a small percentage of cases, a lead point is not found, and intussusception is thought to be idiopathic or secondary to a disease process contributing to dysrhythmic peristalsis of the gastrointestinal tract. A few cases of functional intussusception have been reported as being secondary to severe hyperglycemia and metabolic derangements, including metabolic acidosis and hyperkalemia, by causing impaired gastrointestinal motility. We present a case of a 23-year-old Caucasian male who presented with severe hyperglycemia and diabetic ketoacidosis. Imaging of the abdomen revealed three intussusceptions involving the small intestine, which were easily reduced manually during exploratory laparotomy.

  20. Ileocaecal Intussusception with a Lead Point: Unusual MDCT Findings of Active Crohn’s Disease Involving the Appendix

    Directory of Open Access Journals (Sweden)

    Ebru Ozan

    2015-01-01

    Full Text Available Adult intussusception is a rare entity accounting for 1% of all bowel obstructions. Unlike intussusceptions in children, which are idiopathic in 90% of cases, adult intussusceptions have an identifiable cause (lead point in the majority of cases. Crohn’s disease (CD may affect any part of the gastrointestinal tract, including the appendix. It was shown to be a predisposing factor for intussusception. Here, we report a rare case of adult intussusception with a lead point, emphasizing diagnostic input of multidetector computed tomography (MDCT in a patient with active CD that involves the appendix.

  1. Gastro-oesophageal intussusception in a young German Shepherd Dog

    International Nuclear Information System (INIS)

    Werthern, C.J. von; Montavon, P.M.; Fluckiger, M.A.

    1996-01-01

    A gastro-oesophageal intussusception in a female, six-week-old German shepherd dog was treated surgically with success. The dog was presented with acute dyspnoea and signs of shock. After laparotomy, the herniated organs were reduced from the lumen of the oesophagus into the abdomen and an imbrication of the oesophageal hiatus, an appositional fundoplication and a left-sided incisional fundopexy were performed. The dog made an uneventful recovery. Eighteen months after surgery the dog is still alive, with no clinical signs despite the persistent presence of megaoesophagus

  2. [Post-licensure passive safety surveillance of rotavirus vaccines: reporting sensitivity for intussusception].

    Science.gov (United States)

    Pérez-Vilar, S; Díez-Domingo, J; Gomar-Fayos, J; Pastor-Villalba, E; Sastre-Cantón, M; Puig-Barberà, J

    2014-08-01

    The aims of this study were to describe the reports of suspected adverse events due to rotavirus vaccines, and assess the reporting sensitivity for intussusception. Descriptive study performed using the reports of suspected adverse events following rotavirus vaccination in infants aged less than 10 months, as registered in the Pharmacovigilance Centre of the Valencian Community during 2007-2011. The reporting rate for intussusception was compared to the intussusception rate in vaccinated infants obtained using the hospital discharge database (CMBD), and the regional vaccine registry. The adverse event reporting rate was 20 per 100,000 administered doses, with the majority (74%) of the reports being classified as non-serious. Fever, vomiting, and diarrhea were the adverse events reported more frequently. Two intussusception cases, which occurred within the first seven days post-vaccination, were reported as temporarily associated to vaccination. The reporting sensitivity for intussusception at the Pharmacovigilance Centre in the 1-7 day interval following rotavirus vaccination was 50%. Our results suggest that rotavirus vaccines have, in general, a good safety profile. Intussusception reporting to the Pharmacovigilance Centre shows sensitivity similar to other passive surveillance systems. The intussusception risk should be further investigated using well-designed epidemiological studies, and evaluated in comparison with the well-known benefits provided by these vaccines. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  3. Ileocolic Intussusception in a Leukemic Adult Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ayoub Innabi

    2016-01-01

    Full Text Available We present a rare case of intussusception in a 41-year-old man with acute myeloid leukemia without an evidence of leukemic infiltration of the bowel. The patient presented to the emergency room with right lower quadrant pain. Initially he was diagnosed with typhlitis. CT scan was done and showed ileocolic intussusception without a definitive lead point identified. Patient underwent hemicolectomy and histopathological study of the specimen did not show any leukemic infiltrate. High suspicion of intussusception should be kept in mind with leukemic patients presenting with abdominal pain.

  4. Endoscopic treatment of a large colonic polyp as a cause of colocolonic intussusception in a child.

    Science.gov (United States)

    Suksamanapun, Nutnicha; Uiprasertkul, Mongkol; Ruangtrakool, Ravit; Akaraviputh, Thawatchai

    2010-07-16

    Colocolonic intussusception is an uncommon cause of intestinal obstruction in children. The most common type is idiopathic ileocolic intussusception. However, pathologic lead points occur approximately in 5% of cases. In pediatric patients, Meckel's diverticulum is the most common lead point, followed by polyps and duplication. We present a case of recurrent colocolonic intussusception which caused colonic obstruction in a 10-year-old boy. A barium enema revealed a large polypoid mass at the transverse colon. Colonoscopy showed a colonic polyp, 3.5 centimeters in diameter, which was successfully removed by endoscopic polypectomy.

  5. Type A Dissection Involving Intimo-Intimal Intussusception Through the Aortic Valve.

    Science.gov (United States)

    Armour, Trygve; Armour, Sarah; Reddy, Pingle; Brinster, Derek

    2015-07-15

    The presentation, evaluation, management, and outcome of a case of type A circumferential dissection involving repeated retrograde intussusception of the intimal flap through the aortic valve is described in this case report. Fewer than 20 intimo-intimal intussusception cases have been described since the first report was published by Hufnagel in 1962, and outcomes have typically been poor because of delays in diagnosis. This case shows the potential for a positive outcome when the diagnosis of intimo-intimal intussusception is entertained and confirmed early in the course of treatment. Preoperative computed tomography and intraoperative transesophageal echocardiography were essential in diagnosis and operative planning.

  6. Ileocecal Intussusception with Histomorphological Features of Inflammatory Neuropathy in Adenovirus Infection

    Directory of Open Access Journals (Sweden)

    Elke Kaemmerer

    2009-01-01

    Full Text Available The pathophysiological mechanisms for ileocecal intussusception in children with adenovirus infection are not well characterized. Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception. Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus. To our knowledge, this is the first report suggesting peristalsis disorders from inflammatory neuropathy as additional mechanism in the pathophysiological concept of adenovirus-associated ileocecal intussusception.

  7. Tuberculosis in a renal allograft recipient presenting with intussusception.

    Science.gov (United States)

    Mohapatra, A; Basu, G; Sen, I; Asirvatham, R; Michael, J S; Pulimood, A B; John, G T

    2012-01-01

    Extra-pulmonary tuberculosis (TB) is more common in renal allograft recipients and may present with dissemination or an atypical features. We report a renal allograft recipient with intestinal TB presenting 3 years after transplantation with persistent fever, weight loss, diarrhea, abdominal pain and mass in the abdomen with intestinal obstruction. He was diagnosed to be having an ileocolic intussusception which on resection showed a granulomatous inflammation with presence of acid-fast bacilli (AFB) typical of Mycobacterium tuberculosis. In addition, AFB was detected in the tracheal aspirate, indicating dissemination. He received anti-TB therapy (ATT) from the fourth postoperative day. However, he developed a probable immune reconstitution inflammatory syndrome (IRIS) with multiorgan failure and died on 11(th) postoperative day. This is the first report of intestinal TB presenting as intussusception in a renal allograft recipient. The development of IRIS after starting ATT is rare in renal allograft recipients. This report highlights the need for a high index of suspicion for diagnosing TB early among renal transplant recipients and the therapeutic dilemma with overwhelming infection and development of IRIS upon reduction of immunosuppression and starting ATT.

  8. Intussusception of the small intestine caused by a primary melanoma?

    Science.gov (United States)

    Schoneveld, M; De Vogelaere, K; Van De Winkel, N; Hoorens, A; Delvaux, G

    2012-01-01

    Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma are very rare. We report the case of a 77-year-old man who was admitted to our hospital with epigastric pain, melena and anaemia. After clinical examination, laboratory evaluation and radiological work-up the diagnosis of a jejunal intussusception was made. Exploratory laparoscopy revealed a large tumour arising from the jejunum, approximately 20 cm distal to the angle of Treitz. Small bowel resection with an end-to-end anastomosis was performed. Histological examination showed an intestinal melanoma. There are different theories concerning the origin of malignant melanoma in the small bowel. Although the small and large intestines normally contain no melanocytes, these cells have occasionally been found in the alimentary and respiratory tracts and even in lymph nodes, which supports the theory of a primary origin of melanoma at these sites. Since this was a solitary intestinal lesion and there was no history of cutaneous melanoma, we conclude that this could be an example of a very rare primary melanoma of the small intestine.

  9. Intussusception of the Small Intestine Caused by a Primary Melanoma

    Directory of Open Access Journals (Sweden)

    M. Schoneveld

    2012-01-01

    Full Text Available Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma are very rare. We report the case of a 77-year-old man who was admitted to our hospital with epigastric pain, melena and anaemia. After clinical examination, laboratory evaluation and radiological work-up the diagnosis of a jejunal intussusception was made. Exploratory laparoscopy revealed a large tumour arising from the jejunum, approximately 20 cm distal to the angle of Treitz. Small bowel resection with an end-to-end anastomosis was performed. Histological examination showed an intestinal melanoma. There are different theories concerning the origin of malignant melanoma in the small bowel. Although the small and large intestines normally contain no melanocytes, these cells have occasionally been found in the alimentary and respiratory tracts and even in lymph nodes, which supports the theory of a primary origin of melanoma at these sites. Since this was a solitary intestinal lesion and there was no history of cutaneous melanoma, we conclude that this could be an example of a very rare primary melanoma of the small intestine.

  10. Intussusception in children: Hydrostatic reduction under US guidance - own experience

    International Nuclear Information System (INIS)

    Roik, D.; Brzewski, M.; Biejat, A.; Marcinski, M.

    2008-01-01

    Intussusception in children is a common abdominal emergency. Recent years have brought a New promising method of nonsurgical invagination treatment, hydrostatic reduction under sonographic (US) guidance. The major advantage of this method is lack of the ionized radiation. The aim of our study is to asses the safety and effectiveness of hydrostatic reduction under US guidance used as a first choice method of invagination treatment in our department. >From July 2006 to December 2007, 33 procedures of hydrostatic reduction under US guidance were performed in 27 children, aged from 7 months to 6 years and 10 months. The procedure was performed in US room by radiologist and surgeon with the use of self-constructed set for saline enema. The sedation of patient was routinely performed. The initial procedure was effective in 23 patients (pts) (85%). In 5 pts the recurrence of intussusception occurred and in 3 of them next attempt of the reduction was successful. In 4 cases the initial procedures failed, and those children were operated. Total amount of 6 pts underwent an operation. We do not observe any complications connected with the procedure. Hydrostatic reduction of children intusussception under US-guidance is safe and effective method. Our initial results meet the recommended limits of successful reduction rates. It encouraged us to evaluation and further implementation of this method. Water enema is a first choice method of invagination treatment in our hospital. (authors)

  11. Tracheal left mainstem bronchus and obstructive gastric mucosal intussusception associated with esophageal atresia

    NARCIS (Netherlands)

    Tan, C. J.; Aronson, D. C.; Ekkelkamp, S.; van de Heide-Jalving, M.; Vos, A.

    1995-01-01

    A tracheal left mainstem bronchus and gastric outlet obstruction owing to gastric mucosal intussusception occurred in a child who had esophageal atresia and tracheoesophageal fistula. Bronchography and bronchoscopy, indicated because of persisting atelectasis and ventilation dependency, showed a

  12. A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception.

    Science.gov (United States)

    Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Yazar, Fatih Mehmet; Tepe, Murat; Cengiz, Emrah; Isler, Ali; Vicdan, Halit

    2016-01-01

    Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology. Sertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

  13. Ileocecal Burkitt's Lymphoma Presenting as Ileocolic Intussusception With Appendiceal Invagination and Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Sheng-Mine Wang

    2010-06-01

    Full Text Available Intussusception is a common cause of abdominal pain in children. Although most cases are idiopathic, about 10% of cases have a pathologic lead point. Burkitt's lymphoma is not a common etiology. Burkitt's lymphoma might present primarily as intussusception in children but has rarely been associated with appendicitis. We report a case in which a 10-year-old obese boy who initially presented with acute appendicitis due to ileocolic intussusception with appendiceal invagination. He underwent one-trocar laparoscopy and antibiotic treatment. The symptoms recurred 10 days after discharge. Colonoscopy disclosed ileocecal Burkitt's lymphoma as the pathological lead point. This case emphasizes the importance of the age of the patient and the anatomic location of the intussusception related to possible etiology, and hence the most appropriate surgical procedure.

  14. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    International Nuclear Information System (INIS)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun

    2007-01-01

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  15. Gastric Intussusceptions in a Red Corn Snake (Pantherophis guttatus) Associated with Cryptosporidiosis

    OpenAIRE

    Marjorie Bercier; Whitney Zoll; Justin F. Rosenberg; Robson Giglio; Lenice McCoy; William L. Castleman; Matthew D. Johnson; Darryl J. Heard

    2017-01-01

    A 3-year-old female red corn snake (Pantherophis guttatus) was presented for a three-week history of anorexia and decreased defecations. On physical examination, a soft midbody intracoelomic swelling was palpated. Transcutaneous coelomic ultrasound revealed a target-like mass on a transverse section of the stomach, suggesting the presence of a gastrointestinal intussusception. On exploratory coeliotomy, a double compounded esophagogastric and gastroduodenal intussusception was diagnosed and r...

  16. Imaging Findings of Duodenal Duplication Cyst Complicated with Duodenal Intussusception and Biliary Dilatation

    Directory of Open Access Journals (Sweden)

    Eduardo Torres Diez

    2016-01-01

    Full Text Available Duodenal duplication cyst is an extremely rare congenital anomaly usually diagnosed in childhood. However, it may remain asymptomatic for a long period. In adults it usually manifests with symptoms related to complications as pancreatitis, jaundice, or intussusception. We present the radiology findings of a patient with a duodenal intussusception secondary to a duplication cyst. The usefulness of the magnetic resonance (MR in this case is highlighted.

  17. A comparison of manual versus hydrostatic reduction in children with intussusception: Single-center experience

    Directory of Open Access Journals (Sweden)

    Servet Ocal

    2014-01-01

    Full Text Available Objective: In recent years several techniques have been recommended for intussusception treatment. In this study, an evaluation was made of intussusception cases that presented at our clinic and had reduction applied together with saline under ultrasonography (USG and cases, which were surgically treated. Patients and Methods: A retrospective evaluation was made of the records of 72 cases treated for a diagnosis of intussusception between January 2010 and July 2012. Patients were evaluated demographics, clinical presentation, management strategy, during the hospitalisation and outcome. Results: A total of 72 cases which consists of 44 male and 28 female with age range between 5 and 132 months were treated with a diagnosis of intussusception. USG was applied to all cases on initial presentation. As treatment, hydrostatic reduction (HR together with USG was applied to 47 cases. Of these, the HR was unsuccessful in 13 cases. Surgical treatment was applied to 38 cases. Of these cases, ileocolic intussusception was observed in 30 cases, ileoileal in seven cases and colocolic in one case. Meckel diverticulum was determined in five of these cases, polyps in two cases, lymphoma in two cases, lymph nodule in one case and 28 cases were observed to be idiopathic. There was no mortality in any case. Conclusion: HR together with USG is a safe technique in the treatment of intussusception, which also shortens the duration of hospitalisation and significantly reduces the treatment costs.

  18. Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma

    Directory of Open Access Journals (Sweden)

    Tiziana Casiraghi

    2016-01-01

    Full Text Available Introduction. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions. Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation. A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion. Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%; since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.

  19. Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma.

    Science.gov (United States)

    Casiraghi, Tiziana; Masetto, Alessandro; Beltramo, Massimo; Girlando, Mauro; Di Bella, Camillo

    2016-01-01

    Introduction . Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions). Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation . A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm) was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion . Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%); since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.

  20. Delayed Presentation of Intussusception with Perforation after Splenectomy in Patient with Blunt Abdominal Trauma

    Science.gov (United States)

    Afifi, Ibrahim; Al-Thani, Hassan; Attique, Sajid; Khoschnau, Sherwan; El-Menyar, Ayman; Latifi, Rifat

    2013-01-01

    Adult intussusception (AI) following blunt abdominal trauma (BAT) is a rare surgical condition. We present a case of delayed diagnosis of ileocecal junction intussusception with a perforation of small bowel in a 34-year-old male with a history of fall from height. Initial exploratory laparotomy revealed shattered spleen requiring splenectomy. Initial abdominal computerized tomography scanning (CT) scan showed dilated small bowel with no organic obstruction. Patient started to improve with partial distention and was shifted to rehabilitation unit. On the next day, he experienced severe abdominal distention and vomiting. Abdominal CT showed characteristic intussusception at the distal ileum. Secondary exploratory laparotomy revealed severe adhesions of stomach and small bowel to the anterior abdominal wall with dilated small bowel loops and intussusception near the ileocecal junction with perforation of small bowel. The affected area was resected and side-to-side stapled anastomosis was performed. Though small bowel intussusception is a rare event, BAT patients with delayed symptoms of bowel obstruction should be carefully evaluated for missed intussusception. PMID:24455385

  1. Gastric Intussusceptions in a Red Corn Snake (Pantherophis guttatus Associated with Cryptosporidiosis

    Directory of Open Access Journals (Sweden)

    Marjorie Bercier

    2017-01-01

    Full Text Available A 3-year-old female red corn snake (Pantherophis guttatus was presented for a three-week history of anorexia and decreased defecations. On physical examination, a soft midbody intracoelomic swelling was palpated. Transcutaneous coelomic ultrasound revealed a target-like mass on a transverse section of the stomach, suggesting the presence of a gastrointestinal intussusception. On exploratory coeliotomy, a double compounded esophagogastric and gastroduodenal intussusception was diagnosed and reduced surgically. A gastropexy was also performed to prevent recurrence. On histopathology, the gastric glandular mucosa showed moderate to marked proliferation. Diffusely lining the luminal surface of glandular epithelium and free within the lumen were a myriad of protozoa consistent with Cryptosporidium sp. A diagnosis of chronic proliferative gastritis due to Cryptosporidium sp. was made based on these findings. Intussusceptions are rare in reptiles and are infrequently reported in snakes. This is the first report of a double compounded intussusception in a nonmammalian species and the first report of an intussusception involving the stomach in a snake with gastritis due to Cryptosporidium sp.

  2. Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012-2016.

    Science.gov (United States)

    Satter, Syed M; Aliabadi, Negar; Yen, Catherine; Gastañaduy, Paul A; Ahmed, Makhdum; Mamun, Abdullah; Islam, Khaleda; Flora, Meerjady S; Rahman, Mahmudur; Zaman, K; Rahman, Mustafizur; Heffelfinger, James D; Luby, Stephen P; Gurley, Emily S; Parashar, Umesh D

    2017-09-20

    Rotavirus vaccines have significantly decreased the burden of diarrheal diseases in countries that have introduced them into their immunization programs. In some studies, there has been a small association between rotavirus vaccines and intussusception in post-marketing surveillance, highlighting the importance of tracking incidence before and after vaccine introduction. The objective of this study was to describe the epidemiology of intussusception among Bangladeshi children pre-vaccine introduction. We conducted active, hospital-based surveillance for intussusception at 7 tertiary care hospitals with pediatric surgical facilities during July 2012 to September 2016. Hospitalized children under 2years of age were identified according to Brighton Collaboration level 1 criteria for intussusception. The frequency and proportion of intussusception among overall surgical admissions, as well as the demographic and clinical information of the cases is described. Overall 153 cases of intussusception among children <2years-old were identified at participating sites over the enrolment period, confirmed by Level 1 Brighton criteria. These cases represented 2% of all surgical admissions under 2years of age. One hundred twelve cases (73%) were male; the median age was 7months; and the median duration of hospitalization was 7days. One hundred forty-six (95%) children with intussusception required surgery, and 11 (7%) died. Confirmed cases of intussusception represented nearly 2% of pediatric surgical admissions at tertiary referral centers in Bangladesh during the study period and 7% of children with intussusception died. Given the high burden of rotavirus disease in Bangladesh, vaccine introduction is warranted, however, further studies after introduction of rotavirus vaccine are necessary to determine any association between vaccine and intussusception in this setting. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Rare presentation of pancreatitis secondary to intussusception of duodenal duplication cyst, a pediatric case report

    Directory of Open Access Journals (Sweden)

    Valentina Shakhnovich

    2014-12-01

    Full Text Available Duodenal duplication cysts are rare congenital malformations of which there is limited literature in the pediatric population. The most common presentation in symptomatic patients is abdominal pain and pancreatitis. We present a case of a 14 year old female that presented with emesis, abdominal pain, weight loss, and admission biochemical profile concerning for acute pancreatitis in conjunction with severe hypochloremic, hypokalemic metabolic alkalosis. Further imaging was highly suggestive of duodeno-duodenal intussusception causing obstruction of the pancreatic duct. Patient was taken emergently to the operating room for exploration. Patient underwent laparoscopic assisted reduction of intussusception and resection of duodenal duplication cyst. Patient tolerated the surgery well, and was able to be discharged home in stable condition soon after. There have been no cases reported in the literature that describe pancreatitis secondary to intussusception of duodenal duplication cyst. When diagnosed early, these patients can be safely managed laparoscopically even in emergent settings.

  4. Reduction of intussusception by air insufflation in children: recent three-year experience

    International Nuclear Information System (INIS)

    Lee, In Jae; Lim, Hyo Keun; Lee, Kyung Hwan; Yun, Ku Sub; Seo, Gwy Suk; Bae, Sang Hoon

    1994-01-01

    This study was conducted to evaluate success and perforation rates of pneumatic reduction and to find the predictors of reduction failure. We reviewed 224 cases of pediatric intussusception diagnosed by air-enema between July, 1989 and June, 1992. The mean age was 9.8 months(range, 1 month to 3 years). Logistic regression analysis was used to find predictors of reduction failure. Successful reduction was achieved in 197 cases(87.9% of success rate). Bowel perforation occurred in two cases(0.9% of perforation rate). There were two statistically significant predictors of failure;(1) ileoileocolic intussusception(ρ < .001), (2) long duration of symptom (ρ < .001). Surgery was performed in 26 cases (11.6%), of which seven required bowel resection. Pneumatic reduction is a useful means in the management of pediatric intussusception with a high success rate and no mortality

  5. Synchronous adenocarcinomas of the colon presenting as synchronous colocolic intussusceptions in an adult

    Directory of Open Access Journals (Sweden)

    Chen Chuang-Wei

    2012-12-01

    Full Text Available Abstract Intussusception is uncommon in adults. To our knowledge, synchronous colocolic intussusceptions have never been reported in the literature. Here we described the case of a 59-year-old female of synchronous colocolic intussusceptions presenting as acute abdomen that was diagnosed by CT preoperatively. Laparotomy with radical right hemicolectomy and sigmoidectomy was undertaken without reduction of the invagination due to a significant risk of associated malignancy. The final diagnosis was synchronous adenocarcinoma of proximal transverse colon and sigmoid colon without lymph nodes or distant metastasis. The patient had an uneventful recovery. The case also emphasizes the importance of thorough exploration during surgery for bowel invagination since synchronous events may occur.

  6. Neuroendocrine carcinoma as a rare cause of jejunal intussusception in an adult. Management and literature review.

    Science.gov (United States)

    Sahsamanis, Georgios; Mitsopoulos, Georgios; Deverakis, Titos; Terzoglou, Alexandra; Evangelidis, Paschalis; Dimitrakopoulos, Georgios

    2017-05-01

    Intussusception of the small bowel is an uncommon condition, with the majority of cases being observed during infancy. A number of points are responsible, with benign and malignant lesions of the small intestine being the most common. Herein, we present the case of a 75-year-old male patient with vague abdominal pain and black stool during defecation, who underwent surgery due to jejunal intussusception. Pathology report demonstrated a neuroendocrine carcinoma as the underlying cause for his condition, with no additional metastases during the initial diagnosis. Although a conservative approach for management of intussusception is viable, the possibility of gastric outlet obstruction and the presence of malignancy as the primary point usually lead to urgent surgery. In the case of malignancy, adjuvant chemotherapy or additional symptomatic therapy with close follow-up may be required depending on tumor's grade and aggressiveness.

  7. Ileo-ileal intussusception secondary to a lipoma: a literature review.

    Science.gov (United States)

    Oyen, T L; Wolthuis, A M; Tollens, T; Aelvoet, C; Vanrijkel, J P

    2007-01-01

    Intussusception is rare in adults and it can be a challenge to diagnose on admission. Non-specific and variable signs and symptoms, frequently only occurring episodically, may cause a considerable delay before treatment. However, in 90% a predisposing organic cause can be found in adults. A case is presented of small bowel intussusception secondary to a lipoma in a 54-year-old man in whom diagnosis was suggested by CT-scan. The patient was treated with a laparoscopic-assisted reduction and extracorporeal partial small bowel resection, followed by a latero-lateral anastomosis. This case serves as the basis of a review of small bowel intussusception in adults secondary to lipomas. It focuses on the rarity of the disease, but stresses the need for early referral and investigation in middle-aged patients with recurrent abdominal symptoms.

  8. Appendix Invagination Mimicking Ileocecal Intussusception in a Pediatric Patient: A Case Report.

    Science.gov (United States)

    Aybay, Muhsin Nuh; Erol, Seyit; Kaya, Hasan Emin; Guler, Ibrahim

    2016-11-01

    Appendix invagination is a rare cause of right lower quadrant abdominal pain. Clinical findings are not specific and can mimic a wide range of diseases. An 8-year-old girl was admitted with abdominal pain lasting for 2 weeks. Clinical and radiologic findings suggested ileocecal intussusception initially. A failed hydrostatic reduction attempt and subsequent abdominal ultrasound and computed tomography studies showed that the underlying pathology was invagination of the vermiform appendix. The patient was managed conservatively and spontaneous reduction was observed during follow-up. She underwent appendectomy 9 months later due to chronic appendicitis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Appendix invagination should be kept in mind while evaluating patients with suspected ileocecal intussusception. In distinguishing between these two conditions, a blind-ending invaginating segment is an important clue in favor of appendix intussusception. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Ultrasound-guided hydrostatic reduction of intestinal intussusception: description of three cases

    Directory of Open Access Journals (Sweden)

    Martha Hanemann Kim

    2008-09-01

    Full Text Available With the objective of reporting the technique of ultrasound-guided hydrostatic reduction of intestinal intussusception, three cases with confirmed diagnosis of the disease submitted to reduction with this technique are described. All cases had successful reductions with no complications. One patient experienced a recurrence of the invagination eight days after treatment, which was surgically corrected. The technique of hydrostatic reversal of intestinal intussusception guided by ultrasound may be used in place of the conventional barium enema, since it is a minimally invasive and safe method, with high rates of success and few complications.

  10. Invaginated meckel's diverticulum: A rare cause of small intestine intussusception in adults

    International Nuclear Information System (INIS)

    Rana, N. A.; Rathore, M. O.; Khan, M. U.

    2013-01-01

    Intussusception is commonly seen in infants. It is occasionally found in adults usually due to carcinomas, colonic diverticuli, polyps and rarely Meckel's diverticulum. An adult male presented with upper abdominal pain, nausea, anorexia and loose stools. The initial investigative workup was unremarkable and patient responded to treatment given for acute gastroenteritis. After 3 days, the pain recurred in right iliac fossa with rebound tenderness and leukocytosis. Surgery was performed with provisional diagnoses of acute appendicitis and/or acute Meckel's diverticulitis. Per-operative findings revealed invaginated Meckel's diverticulum causing non-obstructing intussusception. (author)

  11. [Is intestinal malrotation the cause of intussusception? Waugh's syndrome, a case report].

    Science.gov (United States)

    Gil-Vargas, Manuel; Sol-Meléndez, Ana Karen; Miguel-Sardaneta, Mariana Lee

    2016-01-01

    Waugh's syndrome is the combination of intussusception and intestinal malrotation. The first case was described in 1911, with few cases being reported since then. A 7 month-old infant with fever, vomiting and rectal bleeding. Distension and an abdominal mass was found on examination. An exploratory laparotomy was preformed that found a combination of intussusception and intestinal malrotation, which was treated succesfully. We consider that this combination is not sufficiently diagnosed very often, leading to its disappearance. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  12. Understanding about diagnosis of acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT

    International Nuclear Information System (INIS)

    Jiang Ruizhou; Chen Jincheng

    2009-01-01

    Objective: To have a further study of the value of MSCT in diagnosing acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT. Methods: A 46-year-old female patient with the history of abdominal operation was found having acute mechanical small bowel obstruction through plain X-ray radiograph. 64-slice MSCT was performed afterwards (plain scan + 3 stage contrast scans). Hence, evidence is provided for operation. Results: Using the technique of MSCT for the patient can promptly approach the diagnosis of jejuno-jejunal intussusception with severe bowel obstruction; no small bowel tumor or other organic lesion found in this case. With the patient who has the history of abdominal operations, MSCT can predict the reason of adhesion causing bowel intussusception, and provide the evidence for operation; whereas MSCT with contrast media offers a further investigation of the blood supply to the bowels through SMA, and observation of blood circulation through the intussuscepting site, which represents venous congestion of intussusception. This case is a retrograde small bowel intussusception and confirmed with operation evidence. A greater amount of gas and fluid is accumulated between the dilated space of middle-distal portion of intussusceptum and intussuscipiens. Nevertheless, less gas at the proximal portion and that can be an important sign for retrograde intussusception. Conclusion: MSCT is a good choice of examination for diagnosis of adult's intussusception. As the literature mentioned the advantages of MSCT for observing the circulation of intussusceptum and whether the diagnosis is antegrade or retrograde intussusception is also essential. (authors)

  13. Effective dose at pneumatic reduction of paediatric intussusception

    International Nuclear Information System (INIS)

    Heenan, S.D.; Kyriou, J.; Fitzgerald, M.; Adam, E.J.

    2000-01-01

    AIM: The purpose of this study was to assess screening times and resulting dose implication at pneumatic reduction of intussusception in the paediatric age group and to examine the relationship with the outcome of the procedure. MATERIALS AND METHODS: We retrospectively reviewed the case notes and departmental records of 143 children who had undergone a total of 153 pneumatic reductions in our department over a 4-year period. Success rates, screening times and available dose-area products (DAP) were recorded. The DAPs were converted to effective dose (ED) for 77 procedures. RESULTS: A 76.5% (117/153) success rate was achieved with a recurrence rate of 6.5% and only one complication: a perforation. Screening times were recorded in 137 reductions and ranged from 15 s to 22.6 min. Although the longest screening time was associated with an unsuccessful outcome, the second longest time of 21 min was successful. This gave a DAP of 1278 cGy cm 2 and an ED of 12.73 mSv, which is equivalent to approximately 400 abdominal films for a 1-year-old. A lifetime risk of fatal cancer of one in 1000 was achieved, assuming the worst case, after a screening time of 30 min on our conventional fluoroscopy unit. CONCLUSION: Our success rate compares well with other centres. Our institution is a tertiary referral centre and the occasional long screening time may reflect the delay and complex nature of the patients referred. Persistence at air reduction may be successful and the success rate increases with delayed attempts but the risks of the increasing radiation burden must be weighed against the risks of emergency surgery and anaesthesia. Heenan, S.D. (2000)

  14. Giant submucosal lipoma cause colo-colonic intussusception. A case report and review of literature.

    Science.gov (United States)

    Grasso, Emanuele; Guastella, Tommaso

    2012-01-01

    Lipoma of the large intestine is rare, with a reported incidence ranging between 0.2% and 4.4%. We present a case of a giant colonic lipoma causing descending-colonic intussusception. A 54-year-old woman visited our emergency room with sudden onset of intermittent abdominal cramps. She was nauseous and had rectal blood loss for three days. Physical examination showed a tender palpable mass in the left lower abdominal quadrant. Rectal examination showed little blood on the glove. A CT scan demonstrated a clear intussusception of the descending-colonic (Fig. 1). Since the clinical presentation was that of an imminent ileus a laparotomy was performed. The intussusception was found in the descending coloni (Fig. 2), en-bloc resection with left hemicolectomy and was performed with end-to-end anastomosis. Lipomas of the gastrointestinal tract are rare conditions first described by Baurer in 1757. Lipomas in the intestinal tract are still relatively rare, however, being present in only 0.2% of a large autopsy series of 60 000 cases reported in 1955. In 90% of cases, lipoma of the colon are localized at submucous level. Submucosal lipomas are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. Accurate preoperative diagnosis is difficult and lipoma is often mistaken for adenomatous polyp or carcinoma. Differential diagnosis includes malignancy, diverticulosis, adenomatous polyps and previous anastomosis. CT is the examination of choice. Surgical approach remains the treatment of choice for large colon lipoma.

  15. Tuberculosis mimicking ileocecal intussusception in a 5-month-old girl

    NARCIS (Netherlands)

    J.E.M. de Steenwinkel (Jurriaan); G.J.A. Driessen (Gertjan); M.H. Kamphorst-Roemer (Margreet); A.G.M. Zeegers (Antoine); A. Ott (Alewijn); M. van Westreenen (Mireille)

    2008-01-01

    textabstractA 5-month-old girl was diagnosed with tuberculosis, mimicking ileocecal intussusception. The mother of the patient was later diagnosed with renal tuberculosis attributable to the same (unique) Mycobacterium tuberculosis strain. Possibly, that transmission occurred by aspiration or

  16. Sarcomatoid Carcinoma of the lung: A rare case of three small intestinal intussusceptions and literature review

    Directory of Open Access Journals (Sweden)

    Angela Romano

    2015-01-01

    Conclusion: There are rare reports of small intestinal intussusceptions caused by metastatic lung carcinosarcoma, this presentation shows the third case in literature. Physicians should be more alert to symptoms or signs indicating GI metastais in patients with a history of lung cancer.

  17. Laparoscopy-assisted hydrostatic in situ reduction of intussusception: A reasonable alternative?

    Directory of Open Access Journals (Sweden)

    V. V. S. S. Chandrasekharam

    2011-01-01

    Full Text Available Aim: To evaluate an alternative way of reducing intussusceptions under laparoscopic guidance. Materials and Methods: This is a retrospective observational study of children who underwent laparoscopy-assisted hydrostatic in situ reduction of intussusceptions (LAHIRI. Under general anesthesia with laparoscopic vision, warm saline was infused into the rectum with a 16-18 F Foley catheter and a drip set till the intussusception was reduced. Results: Eleven patients [age 7.8 (±2.8 months] were operated over a period of 1 year. Ten (90.9% patients had ileocolic intussusception, which got completely reduced, but one (9% had ileo-ileocolic intusussception, in whom manual reduction by extending the subumbilical incision was required to reduce the ileoileal part. The mean duration of surgery was 38.5 (±6.6 min. No patient had bowel ischemia and there were no intra- or postoperative complications. Conclusions: LAHIRI appears to be an effective and safe technique in children. Specific advantages are that it is performed in a controlled environment in the operating room, avoids patient apprehension and discomfort, avoids bowel handling, provides a safe opportunity to create higher intraluminal pressure, ensures visual assessment of bowel vascularity and completeness of reduction.

  18. Intussusception during pregnancy after laparoscopic Roux-en-Y gastric bypass

    NARCIS (Netherlands)

    Bokslag, Anouk; Jebbink, Jiska; de Wit, Laurens; Oudijk, Martijn; Ribbert, Lucie; Tahri, Sabrin; van Pampus, Mariëlle

    2014-01-01

    In fertile women, the laparoscopic Roux-en-Y gastric bypass (LRYGB) is being increasingly performed. Pregnancy and LRYGB both give an increased risk of intussusception, which can lead to bowel necrosis, sepsis and preterm labour. We describe two pregnant women with a history of LRYGB who presented

  19. Potential intussusception risk versus health benefits from rotavirus vaccination in Latin America.

    Science.gov (United States)

    Desai, Rishi; Parashar, Umesh D; Lopman, Benjamin; de Oliveira, Lucia Helena; Clark, Andrew D; Sanderson, Colin F B; Tate, Jacqueline E; Matus, Cuahtemoc Ruiz; Andrus, Jon K; Patel, Manish M

    2012-05-01

    With the recent postlicensure identification of an increased risk of intussusception with rotavirus vaccine, the 14 Latin American countries currently using rotavirus vaccine must now weigh the health benefits versus risks to assess whether to continue vaccination. To inform policy considerations, we estimated excess intussusception cases and mortality potentially caused by rotavirus vaccine for each of the 14 countries and compared these estimates to hospitalizations and deaths expected to be averted through vaccination. We used regional rotavirus disease burden and rotavirus vaccine efficacy data, global natural intussusception and regional rotavirus vaccine-related risk estimates, and country-specific diphtheria, tetanus, and pertussus vaccination coverage rates to estimate rotavirus vaccine coverage rates. We performed a probabilistic sensitivity analysis to account for uncertainty in these parameters. For an aggregate hypothetical birth cohort of 9.5 million infants in these 14 countries, rotavirus vaccine would annually prevent 144 746 (90% confidence interval [CI], 128 821-156 707) hospitalizations and 4124 deaths (90% CI, 3740-4239) due to rotavirus in their first 5 years of life but could cause an additional 172 hospitalizations (90% CI, 126-293) and 10 deaths (90% CI, 6-17) due to intussusception, yielding benefit-risk ratios for hospitalization and death of 841:1 (90% CI, 479:1 to 1142:1) and 395:1 (90% CI, 207:1 to 526:1), respectively. In an uncertainty analysis using 10 000 simulations of our probabilistic parameters, in comparing rotavirus disease averted to intussusception events caused, the hospitalization ratio was never below 100:1, and our death ratio fell below 100:1 only once. The health benefits of vaccination far outweigh the short-term risks and support continued rotavirus vaccination in Latin America.

  20. The diagnostic role of abdominal CT imaging findings in adults intussusception: Focused on the vascular compromise

    International Nuclear Information System (INIS)

    Park, Sung Bin; Ha, Hyun Kwon; Kim, Ah Young; Lee, Seung Soo; Kim, Hye Jin; Park, Beom Jin; Jin, Yong Hyun; Park, Seong Ho; Kim, Kyoung Won

    2007-01-01

    Intussusception is defined as telescoping of one segment of the gastrointestinal tract into an adjacent one. Unlike that in children, adult intussusception is a relatively rare condition. More than 90% of patients with adult intussusception have been reported to have an organic cause, with benign or malignant tumors for accounting for approximately 65% of the cases. In general, the diagnosis is easily made by means of computed tomography (CT) or magnetic resonance (MR) imaging. The imaging appearance of a bowel-within-bowel configuration with or without contained fat and mesenteric vessels, is pathognomonic. As the intussusceptum enters into the intussuscipiens, the mesentery is carried forward and trapped between the overlapping layers of bowel. The twisting or severe constriction of the mesenteric vessels may result in vascular compromise with subsequent edematous thickening of the involved bowel. In these circumstances, ischemic necrosis may develop if timely intervention is not undertaken. Therefore, determination of the presence or absence of intestinal necrosis in intussusception is important in patient management. On CT, the presence of well-known diagnostic CT criteria for strangulated obstruction (especially severe engorgement or twisting of the mesenteric vessels) as well as evidence of loss of the layered pattern, accumulation of extraluminal fluid collection, and bowel perforation, may suggest the diagnosis of intestinal necrosis. CT and MR imaging are limited in determining the primary disease causing intussusception. However, CT and MR provide excellent pre-operative evaluation, including the possible extension and/or dissemination of a malignant tumor. CT and MR imaging may also be useful in suggesting the presence of vascular compromise

  1. Association between medication and intestinal intussusception in children: a case-crossover study.

    Science.gov (United States)

    Vega García, Lourdes; Fuentes-Leonarte, Virginia; Tenías, José María; Correcher Medina, Patricia; Arias Arias, Ángel; Román Ortiz, Carmen

    2015-04-01

    This study aimed to assess the association between the appearance of intussusception in children and medication intake in the immediately preceding period (2-15 days). A case-crossover design was used. We selected cases of children admitted with a diagnosis of intussusception (International Classification of Diseases, Ninth Revision, 860) to the major hospitals in the city of Valencia, Spain, from 2006 to 2009. We then estimated the association between the episode of intussusception and the intake of prescription medication during the preceding 2, 7, and 15 days (case period) and for the same time window 1, 2, 3, and 4 months prior (control period). Data on previous drug administration were obtained from the Pharmaceutical Service Manager System. A total of 95 cases (65.3% boys and 34.7% girls) were selected; 76.6% were younger than the age of 2 years. The association between intussusception and prior drug use varied depending on the exposure window: 15-day odds ratio (OR), 1.45 (95% confidence interval [95% CI], 0.86-2.43); 7-day OR, 1.46 (95% CI, 0.80-2.67); and 2-day OR, 2.26 (95% CI, 1.10-4.64). These associations were greater for children aged younger than 2 years and were usually due to the recent administration (preceding 2 days) of antibiotics (OR, 8.00; 95% CI, 1.47-43.7). Intussusception was more common among boys aged younger than 2 years. A positive and significant association was observed when drugs were administered 2 to 7 days before the onset of symptoms in children younger than the age of 2 years.

  2. Sonographic Findings of Pediatric Intussusception : Comparison between the Reduced and Non-reduced Group

    International Nuclear Information System (INIS)

    Park, Young Jin; Cha, Soon Joo; Jung, Seong Eun; Kim, Soo Young; Kim, Yong Hoon; Hur, Gam; Lee, Myeung Joon

    1996-01-01

    To determine the negative predictive findings of ultrasonography in intussusception reduction, we compared the ultrasonographic findings in reduced and non-reduced groups in pediatric intussusception. A retrospective evaluation of the 35 non-reduced and 73 reduced cases of intussuception was performed. The diagnosis was made initially by ultrasonography and confirmed by barium enema using gastrografin between 1993 and 1995. Ultrasonographic findings included thickness of outer colonic wall of the intussusception, diameter of the target, number of the lymph nodes, associated ascites and relapsed time after onset of symptoms. The thickness of the outer wall of the intussuception were 4.0∼9.5 mm (mean : 6.08 ± 1.04) in reduced group and 5.3∼11.6 mm (mean : 7.55 ± 1.16) in non-reduced group (p 0.05). Lymph adenopathy was seen in 65 (89%) cases in reduced group and 31 (89%) cases in non-reduced group, and average number of lymph nodes were 1.46 and 1.58 respectively. Ascites was seen in 9 (12.3%) cases of reduced and 12(34.3%) in non-reduced group (p < 0.05). The onset of symptoms presented 24 hours or longer prior to the diagnosis was 17 (23.3%) in reduced group and 17 (48.6%) in non-reduced group (p < 0.05). 7.55 mm or greater outer wall of the intussusception and associated ascites seen in ultrasonography, and the onset of symptoms 24 hours or longer prior to study can be used in negative predictive findings in intussusception reduction

  3. Metastatic osteosarcoma to the small bowel with resultant intussusception: a case report and review of the literature

    International Nuclear Information System (INIS)

    Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; West, Danel C.

    2003-01-01

    Intussusception resulting from osteosarcoma metastasis to the small bowel is a rare diagnosis. This case report describes a patient with this diagnosis, demonstrates the CT appearance of this lesion, and reviews the literature. (orig.)

  4. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    OpenAIRE

    Krasniqi, Avdyl S; Hamza, Astrit R; Salihu, Lulzim M; Spahija, Gazmend S; Bicaj, Besnik X; Krasniqi, Selvete A; Kurshumliu, Fisnik I; Gashi-Luci, Lumturije H

    2011-01-01

    Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdom...

  5. Intussusception of the small bowel secondary to an enterolith from a jejunal diverticulum.

    Science.gov (United States)

    di Marco, Aimee N; Purkayastha, Sanjay; Zacharakis, Emmanouil

    2012-09-01

    We report a case of acute, small bowel obstruction secondary to intussusception caused by an enterolith from a jejunal diverticulum, in an elderly female with a history of chronic, intermittent abdominal pain. Diagnostic work-up of the patient included a computed tomographic (CT) scan which demonstrated the intussusception, but not the enterolith, which was characteristically radiolucent. A laparotomy was performed and the enterolith was found and delivered. A fistula between the gallbladder and small bowel was sought, but not found. Multiple diverticulae were found throughout the small bowel. Although small bowel diverticulosis is rare, it should be considered in the differential diagnosis of the acute abdomen and chronic abdominal pain, especially in those with known colonic diverticulosis, in whom this condition is more common.

  6. A rare case of primary lymphoma of the caecum presenting as intussusception

    Directory of Open Access Journals (Sweden)

    Leena Jayabackthan

    2013-01-01

    Full Text Available Mucosa associated lymphoid tissue (MALT lymphomas are rare neoplasms. They are most common in the stomach followed by small intestine and colon. The symptoms are nonspecific and generally do not present with intussusception. Here we report a rare clinical entity in which a 35-year-old female presented to the emergency with severe abdominal pain which was sudden in onset. History revealed that she had been having vague mild abdominal pain for 2 years. Ultrasonography showed ileocolic intussusception with hypoechoic lesion of 54 × 46 mm seen at the lead point. Emergency laparotomy with the right hemi-colectomy was done. The specimen was sent for histopathological examination which revealed a diagnosis of MALT lymphoma. Awareness of the varied clinical presentation helps in formulating the appropriate therapeutic strategy.

  7. Gastroduodenal intussusception due to gastric schwannoma treated by Billroth II distal gastrectomy: one case report.

    Science.gov (United States)

    Yang, Jia-Hua; Zhang, Min; Zhao, Zhi-Hua; Shu, Yu; Hong, Jun; Cao, Yi-Jun

    2015-02-21

    Schwannomas are rarely observed in the gastrointestinal tract. The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia, gastrointestinal bleeding, and an abdominal mass. Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem. The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein. We present a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a Billroth II distal gastrectomy. In this rare case, the patient had intermittent, colicky abdominal pain, nausea, and vomiting for over 4 wk accompanied by a weight loss. A diagnosis of gastric intussusception was made by computed tomography. A Billroth II distal gastrectomy was then performed, and complete en bloc removal (R0 resection) was achieved. Pathology confirmed a gastric schwannoma through positive immunohistochemical staining for S-100 protein.

  8. INTUSSUSCEPTION IN A CASE OF PEUTZ JEGHER SYNDROME: A CASE REPORT

    OpenAIRE

    Manmadh Rao; Babji; Mahalakshmi D; Sankarao

    2015-01-01

    PeutzJegher syndrome is a rare disorder characterized by mucocutaneous melanin deposits over lips, oral mucosa, fingers and multiple hamartomatous polyps in gastrointestinal tract. These individuals may present with small intestinal intussusception with th ese polyp as lead point. We report a case of 15 year old boy presenting with intestinal obstruction with oral melanin deposits and found to have multiple hamartomatous polyps in small intestine

  9. Intussusception reduction: Effect of air vs. liquid enema on radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, Summer L.; Edgar, J.C.; Anupindi, Sudha A.; Zhu, Xiaowei [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Magill, Dennise; Felice, Marc A. [University of Pennsylvania, Environmental Health and Radiation Safety, Philadelphia, PA (United States)

    2017-10-15

    Both air and radiopaque liquid contrast are used to reduce ileocolic intussusception under fluoroscopy. Some suggest air lowers radiation dose due to shorter procedure times. However, air enema likely lowers radiation dose regardless of fluoroscopy time due to less density over the automatic exposure control cells. We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluoroscopy time. We describe a role for automatic exposure control in this dose difference. We retrospectively evaluated air and liquid intussusception reductions performed on a single digital fluoroscopic unit during a 26-month period. We compared patient age, weight, gender, exam time of day and year, performing radiologist(s), radiographic image acquisitions, grid and magnification use, fluoroscopy time and dose area product. We compared categorical and continuous variables statistically using chi-square and Mann-Whitney U tests, respectively. The mean dose area product was 2.7-fold lower for air enema, 1.3 ± 0.9 dGy.cm{sup 2}, than for liquid, 3.5 ± 2.5 dGy.cm{sup 2} (P<0.005). The mean fluoroscopy time was similar between techniques. The mean dose area product/min was 2.3-fold lower for air, 0.6 ± 0.2 dGy.cm{sup 2}/min, than for liquid, 1.4 ± 0.5 dGy.cm{sup 2}/min (P<0.001). No group differences were identified in other measured dose parameters. Fluoroscopic intussusception reduction using air enema uses less than half the radiation dose of liquid contrast enema. Dose savings are independent of fluoroscopy time and are likely due to automatic exposure control interaction. (orig.)

  10. Metastatic melanoma causing double small intestinal intussusception: diagnosis by computed tomography

    International Nuclear Information System (INIS)

    Bortolucci, G.; Garcia, M.; Dalcim, L.; Dias, I.; Teshirogi, E.

    2011-01-01

    Full text: Introduction: Metastases from malignant melanoma to the gastrointestinal tract are uncommon. Often found in jejunum and ileum, they are responsible for up to 7% of complications pre mortem. These metastases manifest with bleeding, perforation, obstruction or intussusception and require immediate surgery. Intussusception is a rare finding in the report described and is presented in a double into distinct segments. History and Physical Examination: M.H.C.S, female, 50 years, presenting 3 cm ulcerated lesion in the calcaneous region of the right foot with two years of evolution, no signs of infection or neoplastic permeation shores. Surgical excision of the lesion was performed and histopathologic analysis showed non-classifiable malignant melanoma. Submitted material to immunohistochemistry showed that markers of antigens Melan A and HMB45 positive, favoring the diagnosis of malignant melanoma. Tumor resection with expanding margins and selective inguinal lymphadenectomy through the technique of sentinel node, with rates equal to V Clark and Breslow thickness of 1.3 cm. Patient presented with acute abdominal obstruction treated surgically. Despite an uneventful post-operative, brain metastases developed, and patient is currently undergoing chemotherapy. Complementary Exams: Contrasted abdominal CT showing distension of the small bowel and an image suggestive of double intussusception. Treatment and Results: Indicated that laparotomy confirmed the presence of double intussusception in small intestine, the first being 110 cm from the angle of Treitz with a palpable tumor mass and dilatation of the upstream and the second character equal to 220 cm of the same, treated with bowel resection followed by end anastomosis. The diagnosis of malignant melanoma was confirmed by immunohistochemical analysis of surgical specimens. Discussion/Conclusion: Metastatic lesions in the gastrointestinal tract are often asymptomatic or nonspecific. The diagnosis should be

  11. External resection of a giant sigmoid lipoma causing colonic intussusception and prolapse through the anal canal.

    Science.gov (United States)

    Tony, Jose; Saji, Sebastian; Sandesh, K; Sunilkumar, K; Ramachandran, T M; Thomas, Varghese

    2007-01-01

    We depict the case of an 80-year-old female patient who presented to us with a history of protruding mass per anum. Sigmoidoscopy revealed a large globular pedunculated polyp at 22 cm from the anal verge resulting in a sigmoidorectal intussusception. Endoscopic polypectomy was not technically possible due to the large size of the polyp. At the time of prolapse the polyp was tied at its pedicle with thread and resected surgically. The patient is asymptomatic on follow-up.

  12. Intussusception reduction: Effect of air vs. liquid enema on radiation dose

    International Nuclear Information System (INIS)

    Kaplan, Summer L.; Edgar, J.C.; Anupindi, Sudha A.; Zhu, Xiaowei; Magill, Dennise; Felice, Marc A.

    2017-01-01

    Both air and radiopaque liquid contrast are used to reduce ileocolic intussusception under fluoroscopy. Some suggest air lowers radiation dose due to shorter procedure times. However, air enema likely lowers radiation dose regardless of fluoroscopy time due to less density over the automatic exposure control cells. We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluoroscopy time. We describe a role for automatic exposure control in this dose difference. We retrospectively evaluated air and liquid intussusception reductions performed on a single digital fluoroscopic unit during a 26-month period. We compared patient age, weight, gender, exam time of day and year, performing radiologist(s), radiographic image acquisitions, grid and magnification use, fluoroscopy time and dose area product. We compared categorical and continuous variables statistically using chi-square and Mann-Whitney U tests, respectively. The mean dose area product was 2.7-fold lower for air enema, 1.3 ± 0.9 dGy.cm 2 , than for liquid, 3.5 ± 2.5 dGy.cm 2 (P<0.005). The mean fluoroscopy time was similar between techniques. The mean dose area product/min was 2.3-fold lower for air, 0.6 ± 0.2 dGy.cm 2 /min, than for liquid, 1.4 ± 0.5 dGy.cm 2 /min (P<0.001). No group differences were identified in other measured dose parameters. Fluoroscopic intussusception reduction using air enema uses less than half the radiation dose of liquid contrast enema. Dose savings are independent of fluoroscopy time and are likely due to automatic exposure control interaction. (orig.)

  13. Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience

    Directory of Open Access Journals (Sweden)

    Yaw Boateng Mensah

    2011-01-01

    Full Text Available Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great success in many countries. We present our initial experience with fluoroscopic-guided pneumatic reduction of intussusception at Korle Bu Teaching Hospital which is also the first time the technique has been used in Ghana. Materials and Methods: A total of 18 children were enrolled in the study between August 2007 and February 2008 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were given air enema under fluoroscopic-guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 120 mmHg. A total of three attempts of 3 min each were allowed. Results: There were 12 males and 6 females. The average age of the patients was 8.3 months (SD= 3 months. Twelve (67% of the cases were reduced successfully while 6 (33% failed to reduce. A majority of those that did not reduced had symptoms for at least 2 days. Bowel perforation occurred in three (16.7% cases. Conclusion: Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.

  14. Adult suprapatellar pleiomorphic rhabdomyosarcoma with jejunal metastasis causing intussusception : a case report

    OpenAIRE

    Gys, Ben; Peeters, Dieter; Driessen, Ann; Snoeckx, Annemie; Komen, Niels

    2016-01-01

    Abstract: Jejuno-jejunal intussusception is rarely encountered in adults. Management depends on the viability of the involved bowel. Exploration is favored because in adults generally an underlying `lead point' is found to be present. Pleimorphic rhabdomyosarcoma (pRMS) arises from striated muscle cells. They are usually diagnosed during childhood and can occur virtually all over the body, controversially in places were few striated cells are found. In adults, these tumors are rare and are mo...

  15. Technique and outcomes of bladder neck intussusception during robot-assisted laparoscopic prostatectomy: A parallel comparative trial.

    Science.gov (United States)

    Tan, Hung-Jui; Xiong, Siwei; Laviana, Aaron A; Chuang, Ryan J; Treat, Eric; Walsh, Patrick C; Hu, Jim C

    2016-12-01

    Postprostatectomy incontinence significantly impairs quality of life. Although bladder neck intussusception has been reported to accelerate urinary recovery after open radical retropubic prostatectomy, its adaption to robotic surgery has not been assessed. Accordingly, we describe our technique and compare outcomes between men treated with and without bladder neck intussusception during robot-assisted laparoscopic prostatectomy. We performed a comparative trial of 48 men undergoing robot-assisted laparoscopic prostatectomy alternating between bladder neck intussusception (n = 24) and nonintussusception (n = 24). Intussusception was completed using 3-0 polyglycolic acid horizontal mattress sutures anterior and posterior to the bladder neck. We assessed baseline characteristics and clinicopathologic outcomes. Adjusting for age, body mass index, race, and D׳Amico risk classification, we prospectively compared urinary function at 2 days, 2 weeks, 2 months, and last follow-up using the urinary domain of the Expanded Prostate Cancer Index-Short Form. Baseline patient characteristics and clinicopathologic outcomes were similar between treatment groups (P>0.05). Median catheter duration (8 vs. 8d, P = 0.125) and rates of major postoperative complications (4.2% vs. 4.2%, P = 1.000) did not differ. In adjusted analyses, Expanded Prostate Cancer Index-Short Form urinary scores were significantly higher for the intussusception arm at 2 weeks (65.4 vs. 46.6, P = 0.019) before converging at 2 months (69.1 vs. 68.3, P = 0.929) after catheter removal and at last follow-up (median = 7mo, 80.5 vs. 77.0; P = 0.665). Bladder neck intussusception during robot-assisted laparoscopic prostatectomy is feasible and safe. Although the long-term effects appear limited, intussusception may improve urinary function during the early recovery period. Copyright © 2016. Published by Elsevier Inc.

  16. A High Incidence of Intussusception Revealed by a Retrospective Hospital-Based Study in Nha Trang, Vietnam between 2009 and 2011

    Science.gov (United States)

    Tran, Lan Anh T.; Yoshida, Lay Myint; Nakagomi, Toyoko; Gauchan, Punita; Ariyoshi, Koya; Anh, Dang Duc; Nakagomi, Osamu; Thiem, Vu Dinh

    2013-01-01

    Rotavirus is a leading cause of severe diarrhea among children worldwide. Thus, the World Health Organization recommended including rotavirus vaccines in national immunization programs. One concern about rotavirus vaccine, however, is a possible association with intussusception. Thus, it is crucial to know the baseline incidence of intussusception in the first year of life. A study conducted in Hanoi, Vietnam showed that the incidence of intussusception was the highest in the world. This retrospective cross-sectional study was undertaken to determine the incidence of intussusception among children Khanh Hoa Provincial General Hospital where virtually all cases of intussusception occurring in the city were assumed to have been encountered. The incidence of intussusception among children <1 year of age was 296 per 100,000 person-years (95% confidence interval [CI]: 225–382), and that among children <5 years of age was 196 per 100,000 person-years (95% CI: 169–226), confirming the high incidence of intussusception in Vietnam. Nevertheless, there was no intussusception in the first three months of life. We therefore recommend that the first dose of any rotavirus vaccine be administered to infants between 6 and 12 weeks of age. PMID:24155653

  17. Endoglin inhibition leads to intussusceptive angiogenesis via activation of factors related to COUP-TFII signaling pathway.

    Directory of Open Access Journals (Sweden)

    Ruslan Hlushchuk

    Full Text Available Angiogenesis is a highly coordinated, extremely complex process orchestrated by multiple signaling molecules and blood flow conditions. While sprouting mode of angiogenesis is very well investigated, the molecular mechanisms underlying intussusception, the second mode of angiogenesis, remain largely unclear. In the current study two molecules involved in vascular growth and differentiation, namely endoglin (ENG/CD105 and chicken ovalbumin upstream promoter transcription factor II (COUP-TFII were examined to unravel their specific roles in angiogenesis. Down- respectively up-regulation of both molecules tightly correlates with intussusceptive microvascular growth. Upon ENG inhibition in chicken embryo model, formation of irregular capillary meshwork accompanied by increased expression of COUP-TFII could be observed. This dynamic expression pattern of ENG and COUP-TFII during vascular development and remodeling correlated with formation of pillars and progression of intussusceptive angiogenesis. Similar findings could be observed in mammalian model of acute rat Thy1.1 glomerulonephritis, which was induced by intravenous injection of anti-Thy1 antibody and has shown upregulation of COUP-TFII in initial phase of intussusception, while ENG expression was not disturbed compared to the controls but decreased over the time of pillar formation. In this study, we have shown that ENG inhibition and at the same time up-regulation of COUP-TFII expression promotes intussusceptive angiogenesis.

  18. Acute enteritis or gastroenteritis in young dogs as a predisposing factor for intestinal intussusception: a retrospective study.

    Science.gov (United States)

    Rallis, T S; Papazoglou, L G; Adamama-Moraitou, K K; Prassinos, N N

    2000-10-01

    Various types of intestinal intussusception were diagnosed in 29 of 220 young dogs with acute enteritis or gastroenteritis, due to canine parvovirus (85 cases) or presumably to other infectious agents, inflammation or less common hypermotility and metabolic derangements (135 cases). As the other causes of the disease were excluded, acute enteritis or gastroenteritis was considered to be the most likely predisposing factor for the intestinal intussusception. The most common type of intussusception was found to be the ileocolic. Of the 21 dogs that underwent surgical resection and anastomosis of the intestine, 18 dogs recovered completely and three died due to complications. The high survival rate was due to the effective pre-operative, surgical and post-operative therapy.

  19. Incidentally detected small intestine intussusception caused by primary small intenstine carcinoma on {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jong; Oh, So Won; Kim, Yu Kyeong [Dept. of Nuclear MedicineSeoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul (Korea, Republic of)

    2017-09-15

    Small intestine intussusception in adults is a rare condition mainly caused by primary or metastatic small intestine malignancy. Here, we present a 72-year-old male patient who was diagnosed with small intestine cancer that was presented as small intestine intussusception on hybrid {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). The patient was initially referred for an abnormality on a chest radiography and severe anemia. FDG PET/CT showed the lung lesion in the right upper lobe of lung as a high FDG uptake mass. Accidentally, FDG PET demonstrated another intense hypermetabolic intraluminal lesion in the small intestine accompanied with intussusception shown as a circumferential hypermetabolic wall. By pathologic examination, the patient was diagnosed as primary small intestine cancer with lung metastasis. This case highlights usefulness of hybrid FDG PET/CT to identify unexpected malignancy.

  20. Neonatal small intestinal zygomyocosis misdiagnosed as intussusception in a two-day-old child with a review of the literature.

    Science.gov (United States)

    Agrawal, Pallavi; Saikia, Uma; Ramanaathan, Subbaih; Samujh, Ram

    2013-12-01

    Neonatal mucormycosis is caused by fungi belonging to the class Zygomycetes. Clinically, it mimics necrotizing enterocolitis. We describe a case of 2-day-old baby who presented with abdominal distension and vomiting. A clinical diagnosis of intussusception was suspected. An exploratory laprotomy revealed gangrenous bowel wall and no intussusception or any gas-filled vesicles. Histological examination of the gangrenous segment showed transmural ischemic necrosis with fungal hyphae of zygomycosis. The baby is doing well postoperatively at a follow-up of 3 months. Hence, a high degree of clinical suspicion is important in neonates not responding to usual therapy or antibiotics.

  1. Intussusception in a term newborn with duct-dependent congenital heart disease

    Directory of Open Access Journals (Sweden)

    Banu Aydın

    2013-03-01

    Full Text Available Prostaglandin E1 infusion is widely used to maintain patencyof ductus arteriosus in newborns with duct-dependentcongenital heart disease until surgery. ProstaglandinE1 is a lifesaving drug, but it has many side effects includingfever, apnea, bradycardia, hypotension, convulsion,edema, and cortical hyperostosis. The gastrointestinaltract has not been recognized as a major site of seriousadverse effects of prostaglandin E1 infusion, althoughdiarrhea is a well-recognized side effect that usually respondsto dose reduction. In this report, we present acase of intestinal intussusception presumably induced byprostaglandin therapy in a newborn with duct-dependentcongenital heart disease.Key words: Prostaglandin E1, newborn, gastrointestinal

  2. Stent intussusception after thromboaspiration through a platinum chrome stent: a particular case of longitudinal stent deformation.

    Science.gov (United States)

    Mila, Rafael; Vignolo, Gustavo; Trujillo, Pedro

    2015-04-01

    The need to improve stent deliverability has led to the development of thinner and more flexible stents. However, there is concern about decreased longitudinal strength. The number of longitudinal stent deformation reports has dramatically increased. We report a case of stent longitudinal deformation after thromboaspiration through a new generation platinum chrome bare metal stent. Images show an "intussusception effect," an extreme form of the previously described "concertina deformation," as the mechanism of shortening. Since stent technology is constantly evolving, newer devices will probably be designed to have less susceptibility to longitudinal stent deformation.

  3. Sonographic Evaluation and Monitoring of Pneumoperitoneum After Air Enema Reduction for Intussusception.

    Science.gov (United States)

    Zhou, Amy Z; Toporowski, Amy; Tsung, James W

    2018-02-12

    Abdominal radiography and computed tomography scans are standard tests to diagnose pneumoperitoneum. With the growing availability of point-of-care ultrasound, pneumoperitoneum may be diagnosed in settings without easy access to radiography or computed tomography, such as in overcrowded emergency departments or resource-poor environments. The use of point-of-care ultrasound to diagnose or monitor pneumoperitoneum has been described in adult but not pediatric patients. We present a case of point-of-care ultrasound detection of pneumoperitoneum and monitoring for tension pneumoperitoneum, after failed air enema reduction for intussusception in an infant.

  4. A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review.

    Science.gov (United States)

    Takahashi, Toshiaki; Miyano, Go; Kayano, Hajime; Lane, Geoffrey J; Arakawa, Atsushi; Yamataka, Atsuyuki

    2014-01-01

    Colo-colonic intussusception (CI) due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR) and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment.

  5. A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Toshiaki Takahashi

    2014-01-01

    Full Text Available Colo-colonic intussusception (CI due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment.

  6. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    Directory of Open Access Journals (Sweden)

    Bicaj Besnik X

    2011-09-01

    Full Text Available Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum. Conclusions Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.

  7. Acute pancreatitis secondary to duodeno-duodenal intussusception caused by a duodenal membrane, in a patient with intestinal malrotation

    DEFF Research Database (Denmark)

    Larsen, Pernille Oehlenschläger; Pedersen, Mark Ellebæk; Kjærulf Pless, Torsten

    2015-01-01

    Duodeno-duodenal intussusception is often caused by an intraluminal tumour. The condition is rare owing to the retroperitoneal fixation of the duodenum, which is sometime absent in cases of intestinal malrotation. We describe the case of a 19-year old man admitted to hospital with abdominal pain ...

  8. Case of colonic intussusception secondary to mobile cecum syndrome repaired by laparoscopic cecopexy using a barbed wound suture device.

    Science.gov (United States)

    Yamamoto, Tetsu; Tajima, Yoshitsugu; Hyakudomi, Ryoji; Hirayama, Takanori; Taniura, Takahito; Ishitobi, Kazunari; Hirahara, Noriyuki

    2017-09-21

    A 27-year-old man with recurrent right lower quadrant pain was admitted to our hospital. Ultrasonography and computed tomography examination of the abdomen revealed a target sign in the ascending colon, which was compatible with the diagnosis of cecal intussusception. The intussusception was spontaneously resolved at that time, but it relapsed 6 mo later. The patient underwent a successful colonoscopic disinvagination; there was no evidence of neoplastic or inflammatory lesions in the colon and terminal ileum. The patient underwent laparoscopic surgery for recurring cecal intussusception. During laparoscopy, we observed an unfixed cecum on the posterior peritoneum (i.e. a mobile cecum). Thus, we performed laparoscopic appendectomy and cecopexy with a lateral peritoneal flap using a barbed wound suture device. The patient's post-operative course was uneventful, and he continued to do well without recurrence at 10 mo after surgery. Laparoscopic cecopexy using a barbed wound suture device is a simple and reliable procedure that can be the treatment of choice for recurrent cecal intussusception associated with a mobile cecum.

  9. Midgut pain due to an intussuscepting terminal ileal lipoma: a case report.

    LENUS (Irish Health Repository)

    Abbasakoor, Noormuhammad O

    2010-01-01

    ABSTRACT: INTRODUCTION: The occurrence of intussusception in adults is rare. The condition is found in 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. The child to adult ratio is 20:1. CASE PRESENTATION: A 52-year-old Irish Caucasian woman was investigated for a 3-month history of intermittent episodes of colicky midgut pain and associated constipation. Ileocolonoscopy revealed a pedunculated lesion in the terminal ileum prolapsing into the caecum. Computed tomography confirmed a smooth-walled, nonobstructing, low density intramural lesion in the terminal ileum with secondary intussusception. A laparoscopic small bowel resection was performed. Histology revealed a large pedunculated polypoidal mass measuring 4 x 2.5 x 2 cm consistent with a submucosal lipoma. She had complete resolution of her symptoms and remained well at 12-month follow-up. CONCLUSION: This case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation. Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning.

  10. Ileo-ceco-rectal Intussusception Requiring Intestinal Resection and Anastomosis in a Tawny Eagle (Aquila rapax).

    Science.gov (United States)

    Sabater, Mikel; Huynh, Minh; Forbes, Neil

    2015-03-01

    A 23-year-old male tawny eagle (Aquila rapax) was examined because of sudden onset of lethargy, regurgitation, and hematochezia. An intestinal obstruction was suspected based on radiographic findings, and an ileo-ceco-rectal intussusception was confirmed by coelioscopy. A 14.3-cm section of intestine was resected before an intestinal anastomosis was done. Coelomic endoscopic examination confirmed a postsurgical complication of adhesions between the intestinal anastomosis and the dorsal coelomic wall, resulting in a partial luminal stricture and requiring surgical removal of the adhesions. Rectoscopy was useful in diagnosing a mild luminal stricture related to the second surgery. Complete recovery was observed 2 months after surgery. Lack of further complications in the 2 years after surgery demonstrates good tolerance of intestinal resection and anastomosis of a large segment of bowel in an eagle. This report is the first reported case of intussusception in an eagle and emphasizes the potential use of endoscopic examination in the diagnosis as well as in the management of complications.

  11. Intussusception Caused by Yersinia enterocolitica Enterocolitis in a Patient with Sickle Cell Anemia

    Directory of Open Access Journals (Sweden)

    Geetanjali Gupta

    2010-01-01

    Full Text Available Yersinia enterocolitica intussusception is rarely encountered in patients without an underlying susceptibility and is most frequently reported in iron-overloaded patients. This is thought to be related to the unusual use of iron by this microorganism. We present a case of a 5-year old child with intussusception of the terminal ileum caused by Y. enterocolitica whose past medical history was significant for sickle cell disease. This type of presentation is extremely rare. His monthly blood transfusions 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 Y. enterocolitica , and this patient's transfusions left him in an iron overloaded state despite treatment with Deferoxamine. Our patient's unusual presentation of intusssuception was secondary to the mass effect caused by lymphoid hyperplasia, specifically hypertrophied Peyer's patches in the ileum caused by the Y. enterocolitica infection. We believe that our case demonstrates that Y. enterocolitica should be considered a possible pathogen in patients with sickle cell disease, especially if symptoms occur shortly after blood transfusion.

  12. Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction.

    Science.gov (United States)

    Raval, Mehul V; Minneci, Peter C; Deans, Katherine J; Kurtovic, Kelli J; Dietrich, Ann; Bates, D Gregory; Rangel, Shawn J; Moss, R Lawrence; Kenney, Brian D

    2015-11-01

    The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral center. A multidisciplinary team identified drivers for successful quality improvement including educational brochures, a standardized radiologic report, an observation period in the ER with oral hydration challenges, and follow-up phone calls the day after discharge. Patient outcomes were tracked, and quarterly feedback was provided. Of 80 patients identified over a 24-month period, 34 (42.5%) did not qualify for discharge home due to need for surgical intervention (n = 9), specific radiologic findings (n = 11), need for additional intravenous hydration (n = 4), or other reasons (n = 7). Of 46 patients who qualified for discharge, 30 (65.2%) were successfully sent home from the ED. One patient returned with recurrent symptoms that required repeat enema reduction. Sixteen patients were observed and discharged within 23 hours. Adherence with discharge from the ED improved over time. Discharge from the ED was associated with cost savings and improved net margins at the hospital level for each encounter. A sustainable multidisciplinary quality improvement project to discharge intussusception patients from the ED after air-contrast enema reduction was successfully integrated in a high-volume referral center through education, standardized radiologic reporting, and protocoled follow-up. Copyright © 2015 by the American Academy of Pediatrics.

  13. Radiation dose in pneumatic reduction of ileo-colic intussusceptions - results from a single-institution study

    Energy Technology Data Exchange (ETDEWEB)

    Cullmann, Jennifer L.; Heverhagen, Johannes T.; Puig, Stefan [Inselspital, University Hospital Bern, Institute for Diagnostic, Interventional, and Pediatric Radiology, Bern (Switzerland)

    2015-05-01

    Air enema under fluoroscopy is a well-accepted procedure for the treatment of childhood intussusception. However, the reported radiation doses of pneumatic reduction with conventional fluoroscopy units have been high in decades past. To compare current radiation doses at our institution to past doses reported by others for fluoroscopic-guided pneumatic reduction of ileo-colic intussusception in children. Since 2007 radiologists and residents in our department who perform reduction of intussusceptions have received a radiation risk training. We retrospectively analyzed the data of 45 children (5 months-8 years) who underwent a total of 48 pneumatic reductions of ileo-colic intussusception between 2008 and 2012. We analyzed data for screening time and dose area product (DAP) and compared these data to those reported up to and including the year 2000. Our mean screening time measured by the DAP-meter was 53.8 s (range 1-320 s, median 33.0 s). The mean DAP was 11.4 cGy circle cm{sup 2} (range 1-145 cGy circle cm{sup 2}, median 5.45 cGy circle cm{sup 2}). There was one bowel perforation, in a 1-year-old boy requiring surgical revision. Only three studies in the literature presented radiation exposure results on children who received pneumatic or hydrostatic reduction of intussusception under fluoroscopy. Screening times and dose area products in those studies, which were published in the 1990s and in the year 2000, were substantially higher than those in our sample. Low-frequency pulsed fluoroscopy and other dose-saving keys as well as the radiation risk training might have helped to improve the quality of the procedure in terms of radiation exposure. (orig.)

  14. Retrospective hospital based surveillance of intussusception in children in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketing surveillance of rotavirus vaccines.

    Science.gov (United States)

    Lloyd-Johnsen, C; Justice, F; Donath, S; Bines, J E

    2012-04-27

    Evaluation of the safety of rotavirus vaccines, particularly with respect to the risk of intussusception, is recommended for countries planning to introduce rotavirus vaccines into the National Immunisation Program. However, as prospective studies are costly, require time to conduct and may be difficult to perform in some settings, retrospective hospital based surveillance at sentinel sites has been suggested as an option for surveillance for intussusception following introduction of rotavirus vaccines. To assess the value of retrospective hospital based surveillance to describe clinical and epidemiological features of intussusception in children aged vaccine and intussusception. A retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne, Australia over an 8-year period including before and after rotavirus vaccine introduction into the National Immunisation Program, was conducted using patients identified by a medical record database (ICD-10-CM 56.1). Patient profile, clinical presentation, treatment and outcome were analysed along with records of immunisation status obtained using the Australian Childhood Immunisation Register. A 9% misclassification rate of discharge diagnosis of intussusception was identified on critical chart review. The incidence rate of intussusception at the Royal Children's Hospital over the study period was 1.91 per 10,000 infants vaccination in 2 of 27 patients who had received at least 1 dose of a rotavirus vaccine. Valuable data on the incidence, clinical presentation and treatment outcomes of intussusception can be obtained from data retrieved from hospital medical records in a sentinel paediatric hospital using standardised methodology. However, there are methodological limitations and the quality of the data is highly dependent on the accuracy and completeness of the patient information recorded, the system of coding and record retrieval. Copyright © 2011 Elsevier Ltd. All

  15. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature; Sindrome de Peutz-Jeghers e intussuscepcao - relato de um caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Centro de Diagnostico por Imagem; Costacurta, Marco Antonio [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Radiologia Geral; Albertotti, Cesar Jose [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Tomografia Computadorizada; Cerri, Giovanni Guido [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Ultra-Som

    2000-02-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  16. Jejunogastric intussusception presented with hematemesis: a case presentation and review of the literature

    Directory of Open Access Journals (Sweden)

    Papastratis George

    2001-01-01

    Full Text Available Abstract Background Jejunogastric intussusception (JGI is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. To avoid mortality early diagnosis and prompt surgical intervention is mandatory. Case presentation A young man presented with epigastric pain and bilous vomiting followed by hematemesis,10 years after vagotomy and gastrojejunostomy for a bleeding duodenal ulcer. Emergency endoscopy showed JGI and the CT scan of the abdomen was compatible with this diagnosis. At laparotomy a retrograde type II, JGI was confirmed and managed by reduction of JGI without intestinal resection. Postoperative recovery was uneventful. Conclusions JGI is a rare condition and less than 200 cases have been published since its first description in 1914. The clinical picture is almost diagnostic. Endoscopy performed by someone familiar with this rare entity is certainly diagnostic and CT-Scan of the abdomen could also help. There is no medical treatment for acute JGI and the correct treatment is surgical intervention as soon as possible.

  17. Idiopathic postoperative ileo-colic intussusception in an adult with rectal cancer

    Directory of Open Access Journals (Sweden)

    Marc Paul Jose Lopez

    2016-09-01

    Full Text Available A 39-year-old female presented with symptoms of complete gut obstruction caused by a locally advanced rectal malignancy. She underwent a mini-laparotomy and creation of a proximal transverse loop colostomy (TLC. No other points of obstruction were noted. Post-operatively, clinical and radiological evidence of gut obstruction prompted a re-exploration. This revealed an ileo-colic intussusception. A right hemicolectomy was performed. No identifiable lead point was documented. The patient later underwent long course chemoradiation to address the locally advanced tumor. She, eventually, had a low anterior resection. In this study, it was illustrated that prompt and vigilant detection of such rare occurrences allow for the institution of a management plan that maintains adherence to oncologic principles. [Arch Clin Exp Surg 2016; 5(3.000: 187-189

  18. Mantle Cell Lymphoma of Intestine Presenting as Multiple Lymphomatous Polyposis with Intussusception

    Directory of Open Access Journals (Sweden)

    Meena N. Jadhav

    2015-01-01

    Full Text Available Mantle Cell Lymphoma (MCL is a distinct clinicopathological subtype of B-cell non-Hodgkin's lymphoma (NHL accounting for 2-10% of all NHL cases. Gastrointestinal tract (GIT is the predominant site of extranodal MCL which commonly presents as Multiple Lymphomatous Polyposis (MLP. A 60 year old male presented with pain abdomen, diarrhea and weight loss of two months duration. On colonoscopy multiple polyps were found in the entire colon and rectum. Computed tomography revealed ileo-colic intussusception with nodularity in the lead point. Histopathology suggested features of MCL. On immunohistochemistry, the tumor cells were positive for CD20, CD5, Cyclin D1, negative for CD3, CD10, CD23, and CD45 RO

  19. Associations of Adenovirus Genotypes in Korean Acute Gastroenteritis Patients with Respiratory Symptoms and Intussusception

    Directory of Open Access Journals (Sweden)

    Jae-Seok Kim

    2017-01-01

    Full Text Available Human adenoviruses (HAdVs cause a wide range of diseases, including respiratory infections and gastroenteritis, and have more than 65 genotypes. To investigate the current genotypes of circulating HAdV strains, we performed molecular genotyping of HAdVs in the stool from patients with acute gastroenteritis and tried to determine their associations with clinical symptoms. From June 2014 to May 2016, 3,901 fecal samples were tested for an AdV antigen, and 254 samples (6.5% yielded positive results. Genotyping using PCR and sequencing of the capsid hexon gene was performed for 236 AdV antigen-positive fecal specimens. HAdV-41, of species F, was the most prevalent genotype (60.6%, followed by HAdV-2 of species C (13.8%. Other genotypes, including HAdV-3, HAdV-1, HAdV-5, HAdV-6, HAdV-31, HAdV-40, HAdV-12, and HAdV-55, were also detected. Overall, 119 patients (50.4% showed concomitant respiratory symptoms, and 32 patients (13.6% were diagnosed with intussusception. HAdV-1 and HAdV-31 were significantly associated with intussusception (P<0.05. Our results demonstrate the recent changes in trends of circulating AdV genotypes associated with gastroenteritis in Korea, which should be of value for improving the diagnosis and developing new detection, treatment, and prevention strategies for broad application in clinical laboratories.

  20. Mantle cell lymphoma of the gastrointestinal tract presenting with multiple intussusceptions – case report and review of literature

    Directory of Open Access Journals (Sweden)

    Abo Stephen M

    2009-07-01

    Full Text Available Abstract Background Mantle cell lymphoma (MCL is an aggressive type of B-cell non-Hodgkin's lymphoma that originates from small to medium sized lymphocytes located in the mantle zone of the lymph node. Extra nodal involvement is present in the majority of cases, with a peculiar tendency to invade the gastro-intestinal tract in the form of multiple lymphomatous polyposis. MCL can be accurately diagnosed with the use of the highly specific marker Cyclin D1. Few cases of mantle cell lymphoma presenting with intussuception have been reported. Here we present a rare case of multiple intussusceptions caused by mantle cell lymphoma and review the literature of this disease. Case presentation A 68-year-old male presented with pain, tenderness in the right lower abdomen, associated with nausea and non-bilious vomiting. CT scan of abdomen revealed ileo-colic intussusception. Laparoscopy confirmed multiple intussusceptions involving ileo-colic and ileo-ileal segments of gastrointestinal tract. A laparoscopically assisted right hemicolectomy and extended ileal resection was performed. Postoperative recovery was uneventful. The histology and immuno-histochemistry of the excised small and large bowel revealed mantle cell lymphoma with multiple lymphomatous polyposis and positivity to Cyclin D1 marker. The patient was successfully treated with Rituximab-CHOP chemotherapy and remains in complete remission at one-year follow-up. Conclusion This is a rare case of intestinal lymphomatous polyposis due to mantle cell lymphoma presenting with multiple small bowel intussusceptions. Our case highlights laparoscopic-assisted bowel resection as a potential and feasible option in the multi-disciplinary treatment of mantle cell lymphoma.

  1. Value of imaging in intestinal intussusception in adults. Report of a case of ileocolic intussusception secondary to caecal lipoma; Apport de l`imagerie dans les invaginations intestinales de l`adulte. A propos d`un cas d`invagination ileo-colique, secondaire a un lipome caecal

    Energy Technology Data Exchange (ETDEWEB)

    Ferrokh, D.; Saadaoui, H.; Hainaux, B. [Universite Libre de Bruxelles (Belgium)

    1996-12-31

    On the basis of a case of ileocolic intussusception in a 35-years-old patient secondary to an obstructive lipoma of the caecum, the authors review the literature and discuss the clinical and radiological aspects of this disease. The diagnosis was established by CT scan and barium enema before surgery. Adult intussusception is a rare disease, which does not have any specific clinical features. Radiological imaging is the only complementary investigation which can suggest the diagnosis. (author)

  2. Jejunojejunal Intussusception as the Initial Presentation of Non-Hodgkin’s B-Cell Lymphoma in an Adult Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    V. Stohlner

    2013-01-01

    Full Text Available Introduction. Intussusception is a rare cause of bowel obstruction in adults and is usually associated with an underlying pathology, benign, or malignant. This is a report of a case of jejunojejunal intussusception secondary to non-Hodgkin’s B-cell lymphoma in an adult patient. Case Presentation. A 74-year-old male with no previous significant medical history presented with symptoms of acute intestinal obstruction. A CT scan of the abdomen and pelvis revealed 2 areas of jejunojejunal intussusception, which were surgically managed successfully. Histopathological examination of the specimen revealed the presence of high grade diffuse large B-cell-type non-Hodgkin’s lymphoma, and the patient was referred to the oncology team for further management. Discussion. B-cell lymphoma is a rare but well-documented cause of intussusception in adults, with most cases being at the ileocolic region. We present a rare case of jejunojejunal intussusception as the initial presentation of non-Hodgkin’s B-cell lymphoma in an adult patient.

  3. PREDICTING THE COURSE AND OUTCOME OF THE TREATMENT OF INTUSSUSCEPTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    S. V. Veselyi

    2015-09-01

    Full Text Available The catamnesis in 150 children with an intussusception in terms from 6 months till 10 years after surgical intervention is investigated. Complex biochemical and immunological inspection is carried out to 30 patients. Besides morphological research 10 bioptats of the taken parietal peritoneum, is carried out during operative treatment. Studying before-, intra-and postoperative condition of patients, and also forecasting of current and outcome of disease carried out as a result of search of the «risk factors» determining probability of occurrence and gravity of clinical current of the invagination of intestine in children. In the early postoperative period 4 children (2.7 % have died in connection with an incompetence of the anastomosis, plural intestinal fistulas and progressing of the peritonitis. Catamnesis observation has revealed, that 104 (69.3 % the child after operative desinvagination grew and developed according to age. 34 patients (22.7 % further had the gastroenteropathy described periodic dysphagia and dyspepsia by the phenomena. In 12 children (8.0 % the adhesive disease has developed. Patients with high risk of occurrence of late complications after operative desinvagination require long-term observation and rehabilitation actions.

  4. Anaesthetic Management of a patient with Myasthenia Gravis and Small Bowel Intussusception for Jejuno-Ileal Anastomoses

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    Pawan Kumar Jain

    2016-01-01

    Full Text Available Myasthenia gravis is a chronic autoimmune disease affecting voluntary skeletal muscles. The altered sensitivity of acetylcholine receptors to muscle relaxants and concomitant treatment with anticholinesterase in these patients affect their anaesthetic management. Patients who have undergone bowel anastomosis and are on regular anticholinesterase treatment are susceptible to anastomotic leaks. We report successful anaesthetic management of class I myasthenic patient with coexisting small bowel intussusception operated for jejuno-ileal anastomoses using regional, inhalational and intravenous (i.v anaesthesia based on train of four responses, and avoiding the use of reversal (anticholinesterase.

  5. Henoch-Schönlein purpura complicated by acalculous cholecystitis and intussusception, and following recurrence with appendicitis.

    Science.gov (United States)

    Özkaya, Ahmet Kağan; Güler, Ekrem; Çetinkaya, Ahmet; Karakaya, Ali Erdal; Göksügür, Yalçın; Katı, Ömer; Güler, Ahmet Gökhan; Davutoğlu, Mehmet

    2016-05-01

    Henoch-Schönlein purpura (HSP) is the most common childhood systemic vasculitis. Gastro-intestinal involvement occurs in two-thirds of patients. The characteristic skin lesions generally precede abdominal symptoms or present concurrently. A 7-year-old boy presented with intussusception and acalculous cholecystitis and had a cholecystectomy. Two weeks later he was re-admitted with features typical of HSP which responded to corticosteroids. Eleven months later he presented with abdominal pain and recurrence of HSP and, at laparotomy, there was acute appendicitis. This is the first case of a child presenting with HSP complicated by acalculous cholecystitis.

  6. Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    Nährig Jörg

    2010-06-01

    Full Text Available Abstract Background Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass. Case presentation A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain. The clinical picture mimicked acute appendicitis. Transabdominal ultrasound examination revealed a 5 cm circular mass in the right upper abdomen. The ensuing computed tomography suggested an intussusception in the ascending colon. Intraoperatively, no full thickness invagination was detected. Due to a hard, intraluminal tumor a standard right hemicolectomy with ileotransversostomy was performed. The histopathological analysis revealed a cystic colon duplication leading to mucosal invagination and obstruction. Conclusions In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions. Unlike its preferentially nonsurgical management in children, a bowel intussusception in adults should be operated because an organic, often malignant lesion is present in most cases.

  7. Sonography-guided hydrostatic reduction of ileocolic intussusception in children: analysis of failure and success in consecutive patients presenting timely to the hospital.

    Science.gov (United States)

    Menke, Jan; Kahl, Fritz

    2015-03-01

    In children with ileocolic intussusception sonography is increasingly being used for diagnosis, whereas fluoroscopy is frequently used for guiding non-invasive reduction. This study assessed the success rate of radiation-free sonography-guided hydrostatic reduction in children with ileocolic intussusception, using novel well-defined success rate indices. All children were evaluated who presented from 2005 to 2013 to the local university hospital with ileocolic intussusception. The patients were treated with sonography-guided hydrostatic reduction unless primary surgery was clinically indicated. The according success rate was determined by indices of Bekdash et al. They represent the ratio of persistently successful non-surgical reductions versus four different denominators, depending on including/excluding cases with primary surgery and including/excluding cases requiring bowel resection/intervention. Fifty-six consecutive patients were included (age, 3 months to 7.8 years). About 80% of the patients presented until 24 h and 20% until 48 h after the onset of symptoms. Seven patients underwent primary surgery, with bowel resection required in three cases. Hydrostatic reduction was attempted in 49 patients, being permanently successful in 41 cases (selective reduction rate 41/49 = 83.7%; crude reduction rate 41/56 = 73.2%). The remaining eight patients underwent secondary surgery, with just two patients not requiring surgical bowel resection/intervention (corrected selective reduction rate 41/43 = 95.3%). The composite reduction rate was 87.2% (successful/feasible reductions, 41/47). Radiation-free sonography-guided hydrostatic reduction has a good success rate in children with ileocolic intussusception. It may be particularly valuable in centers that are already experienced with using sonography for the diagnosis.

  8. Small Bowel Obstruction Secondary to Retrograde Intussusception of the Roux Limb: A Complication Following Laparoscopic Roux–en–Y Gastric Bypass.

    Directory of Open Access Journals (Sweden)

    Ayodele Atolagbe

    2016-07-01

    Full Text Available Small bowel obstruction secondary to intussusception following a roux-en-Y gastric bypass (RYGB for morbid obesity is a rare clinical condition. It has become more frequently diagnosed with the increasing utilization of RYGB for the management of morbid obesity world-wide. We present a 34 year old female who presented at the Emergency Room of our facility with complaints of abdominal pain and a history of retro-colic and ante-gastric laparoscopic Roux-en-Y gastric bypass surgery at another Hospital a year prior to presentation. On account of unremitting abdominal pain, a lactate level of 5.4mg/dl and abdominal Computed Tomographic scan which showed evidence of small bowel obstruction with intussusception; an emergency exploratory laparotomy was done which revealed intussusception of the biliopancreatic and common limb into the distal aspect of the roux limb. Surgical intervention entailed resection of both the proximal common limb and distal roux and biliopancreatic limbs and surgical reconstruction of the jejunojejunal anastomosis. She is alive and well two years post surgery without any recurrence.

  9. Multiple Lymphomatous Polyposis of the Intestine with Ileocecal Intussusception Due to Mantle Cell Lymphoma: A Case Report of a 34-Year-Old Man.

    Science.gov (United States)

    Xie, Chuan-Gao; Xu, Xiao-Ming; Wei, Shu-Mei

    2018-03-08

    BACKGROUND Multiple lymphomatous polyposis of the gastrointestinal tract can be associated with the B-cell lymphoma variant, mantle cell lymphoma, with most cases having been described in patients who are more than 50 years-of-age. A rare case of multiple lymphomatous polyposis due to mantle cell lymphoma is reported in a 34-year-old man. CASE REPORT A 34-year-old man presented with paroxysmal abdominal pain followed by spontaneous remission, which had been previously diagnosed as gastritis. An episode of ileocecal intussusception occurred, which was confirmed on imaging studies. The diagnosis of multiple lymphomatous polyposis due to mantle cell lymphoma was confirmed following ileocecal resection and histopathology. The patient refused to receive chemotherapy following surgery. Currently, at two-year follow-up, no further abnormality has been found. A review of the literature has shown the importance of endoscopic evaluation in the diagnosis of lymphomatous polyposis. CONCLUSIONS Multiple lymphomatous polyposis due to mantle cell lymphoma has rarely been described in young patients under the age of 50 years. Gastrointestinal endoscopic examination is important for the early diagnosis of multiple lymphomatous polyposis.

  10. A very rare case of a small bowel leiomyosarcoma leading to ileocaecal intussusception treated with a laparoscopic resection: a case report and a literature review.

    Science.gov (United States)

    Guzel, Tomasz; Mech, Katarzyna; Mazurkiewicz, Michał; Dąbrowski, Bohdan; Lech, Gustaw; Chaber, Andrzej; Słodkowski, Maciej

    2016-02-24

    Small bowel tumours are rare and comprise less than 2% of all primary gastrointestinal neoplasms. Among these tumours, a leiomyosarcoma belonging to soft tissue sarcomas is extremely rare and accounts for about 1 % of malignant mesenchymal lesions in the gastrointestinal tract. Due to its aggressive nature and slow growth, it is often diagnosed at the late stage when curative treatment is impossible. Authors report a first case of leiomyosarcoma with chronic recurrent ileocaecal intussusception and literature review to analyse diagnosis and treatment features of the ileum mesenchymal tumours. We present a case of an 87-year-old Caucasian man suffering from cramp-like abdominal pain for months. Due to lack of clinical signs and unspecific complaints, a diagnosis was delayed. Despite a detailed in-hospital examination, a proper diagnosis was established as late as during an operation. The patient was treated by surgery with good results. An uncommon laparoscopic resection of the small bowel with a tumour was performed. A histopathological investigation confirmed a very rare mesenchymal lesion of the distal ileum. The patient is under control with no recurrence for 1 year of the follow-up period. Reported case indicates that a usually asymptomatic tumour can cause uncommon chronic recurrent ileus signs. CT and MRI scans are investigation of choice in such cases, but they are sometimes inconclusive. It might be worth highlighting the good results of laparoscopic leiomyosarcoma lesion resection with a very good outcome.

  11. Case report of severe Cushing's syndrome in medullary thyroid cancer complicated by functional diabetes insipidus, aortic dissection, jejunal intussusception, and paraneoplastic dysautonomia: remission with sorafenib without reduction in cortisol concentration.

    Science.gov (United States)

    Hammami, Muhammad M; Duaiji, Najla; Mutairi, Ghazi; Aklabi, Sabah; Qattan, Nasser; Abouzied, Mohei El-Din M; Sous, Mohamed W

    2015-09-09

    Normalization of cortisol concentration by multikinase inhibitors have been reported in three patients with medullary thyroid cancer-related Cushing's syndrome. Aortic dissection has been reported in three patients with Cushing's syndrome. Diabetes insipidus without intrasellar metastasis, intestinal intussusception, and paraneoplastic dysautonomia have not been reported in medullary thyroid cancer. An adult male with metastatic medullary thyroid cancer presented with hyperglycemia, hypernatremia, hypokalemia, hypertension, acne-like rash, and diabetes insipidus (urine volume >8 L/d, osmolality 190 mOsm/kg). Serum cortisol, adrenocorticoitropic hormone, dehydroepiandrostenedione sulfate, and urinary free cortisol were elevated 8, 20, 4.4, and 340 folds, respectively. Pituitary imaging was normal. Computed tomography scan revealed jejunal intussusception and incidental abdominal aortic dissection. Sorafenib treatment was associated with Cushing's syndrome remission, elevated progesterone (>10 fold), normalization of dehydroepiandrostenedione sulfate, but persistently elevated cortisol concentration. Newly-developed proximal lower limb weakness and decreased salivation were associated with elevated ganglionic neuronal acetylcholine receptor (alpha-3) and borderline P/Q type calcium channel antibodies. Extreme cortisol concentration may have contributed to aortic dissection and suppressed antidiuretic hormone secretion; which combined with hypokalemia due cortisol activation of mineralocorticoid receptors, manifested as diabetes insipidus. This is the first report of paraneoplastic dysautonomia and jejunal intussusception in medullary thyroid cancer, they may be related to medullary thyroid cancer's neuroendocrine origin and metastasis, respectively. Remission of Cushing's syndrome without measurable reduction in cortisol concentration suggests a novel cortisol-independent mechanism of action or assay cross-reactivity. Normalization of dehydroepiandrostenedione

  12. Recurrent small intestine intussusception in a patient with Peutz-Jeghers syndrome Invaginación recurrente del intestino delgado en un paciente con síndrome de Pentz-Jeghers

    Directory of Open Access Journals (Sweden)

    Orestis Ioannidis

    2012-01-01

    Full Text Available Peutz-Jeghers syndrome is a rare hereditary autosomal dominant disease caused by a mutation of the tumor suppressor gene serine/threonine kinase 11 located in chromosome 19p13.3. It is characterized by the presence of extensive mucocutaneous pigmentation, especially of the lips and the occurrence of hamartomatous polyps throughout the gastrointestinal tract. Gastrointestinal hamartomas occur predominantly in the small intestine and can become symptomatic leading usually to intestinal obstruction and abdominal pain. We present a case of recurrent intestinal obstruction caused by small bowel intussusception treated by reduction, enterotomy and polypectomy and followed by intraoperative enteroscopy and endoscopic polypectomy.

  13. Heterotopic pancreas in Meckel′s diverticulum in a 7-year-old child with intussusception and recurrent gastrointestinal bleeding: Case report and literature review focusing on diagnostic controversies

    Directory of Open Access Journals (Sweden)

    Guanà Riccardo

    2014-01-01

    Full Text Available Meckel′s diverticulum, the most common congenital abnormality of the small intestine, may be associated to heterotopic pancreas, often diagnosed incidentally on histopathological examination. Intussusception affects infants between the ages of 5 and 9 months, but it may also occur in older children, teenagers and adults, and in some cases can be derived by a Meckel′s diverticulum resulting in acute abdomen. We analyse the management and the recent literature on similar cases, describing diagnostic options. In May 2013, a 7-year-old girl admitted to our hospital with recurrent gastrointestinal bleeding, was discovered to have an ileoileal intussusception with a leading Meckel′s diverticulum with heterotopic pancreatic tissue. This association is rare evidence in children and its proper management can be controversial, in particular from a diagnostic point of view. In such cases, preoperative radiological diagnosis can be only suspected in the presence of suggestive signs, more often depicted by ultrasound or computed tomography scan. During laparotomy an accurate exploration of all ileum is recommended, for the possibility to find others heterotopic segments.

  14. INTESTINAL INTUSSUSCEPTION DUE TO CONCURRENT ...

    African Journals Online (AJOL)

    Administrator

    Hymenolepis nana and Dentostomella ... worms (H. nana and D. translucida) were observed in the lumen of the intestine with severe cellular infiltration .... helminthosis and Balantidosis in Red monkey (Erythrocebus patas) in Ibadan Nigeria Nigerian ...

  15. Stapled trans-anal rectal resection (STARR) by a new dedicated device for the surgical treatment of obstructed defaecation syndrome caused by rectal intussusception and rectocele: early results of a multicenter prospective study.

    Science.gov (United States)

    Renzi, Adolfo; Talento, Pasquale; Giardiello, Cristiano; Angelone, Giovanni; Izzo, Domenico; Di Sarno, Giandomenico

    2008-10-01

    Obstructed defaecation syndrome (ODS) represents a very common clinical problem. The aim of the this prospective multicenter study was to evaluate the efficacy and safety of stapler trans-anal rectal resection (STARR) performed by a new dedicated device, CCS-30 Contour Transtar, in patients with ODS caused by rectal intussusception (RI) and/or rectocele (RE). All the patients who underwent STARR for ODS caused by RI and/or RE at Colorectal Surgery Units of S. Stefano Hospital, Naples, Gepos Hospital, Telese, Benevento and S. Maria della Pietà Hospital, Casoria, Naples, Italy were prospectively introduced into a database. Preoperatively, all the patients underwent anorectal manometry and cinedefecography. The grade of ODS was assessed using a dedicated obstructed defaecation syndrome score (ODS-S). All the patients with a ODS-S >or=12 and RI and/or RE were enrolled. Patients were followed up clinically at 6 months. Thirty patients, 28 (93.3%) women, mean age 56.6+/-12.7 years, underwent STARR, by Transtar, between February and October 2006. Preoperatively, ODS-S was 15.8+/-2.4. RI was present in 26 (89.6%) and RE (34.4+/-15.2 mm) in 27 (93.1%) patients. No major postoperative complications occurred. The length of hospital stay was 2.5+/-0.6 days. At 6-month follow-up, ODS-S was 5.0+/-2.3 (P<0.001). Successful outcome was achieved in 25 (86.2%) patients. STARR, performed by the new dedicated device, CCS-30 Contour Transtar, seems to be an effective and safe procedure to treat ODS caused by RE and/or RI. A longer follow-up and a larger number of patients is needed to confirm these results.

  16. Multiple Intussusceptions Associated with Polycythemia in an ...

    African Journals Online (AJOL)

    of testosterone and act on various tissues via androgen receptors to produce anabolic effects (i.e., Increasing protein synthesis), as well as androgenic effects, (i.e., Development of secondary sexual characteristics).[1,2] In addition, they displace ... production of cortisol would equate to about 10–50 mg of exogenously ...

  17. Unusual colocutaneous fistula from intussuscepted paediatric ...

    African Journals Online (AJOL)

    Occurrence of Non-Hodgkin lymphoma in the colon of children is extremely rare. Ignorance, nonavailability of experts and poverty affect management of affected patients. Descending colon and sigmoid colon are very uncommon sites for the involvement of Non-Hodgkin lymphoma and less than 10 cases involving children ...

  18. Intestinal intussusception due to concurrent infections with ...

    African Journals Online (AJOL)

    Hymenolepis nana and Dentostomella translucida) was observed in an African giant rat (Cricetomys gambianus, Waterhouse, 1840). The condition was observed as an incidental finding before an experimental dissection of the animals in the ...

  19. ILEOCOLIC INTUSSUSCEPTION IN A COCKER SPANIEL DOG: A CASE REPORT

    OpenAIRE

    M. A. Khan, M. M. Ali, S. Azeem, A. Safdar, Ijaz A. Ziaullah and M. T. Sajjad

    2011-01-01

    A four-years-old female cocker spaniel dog was presented with a history of vomiting and tenesmus for the last six days. There was no defecation, only fresh blood was coming from rectum and the animal was taking only a few sips of water for last two days. Physical examination revealed that the animal was dehydrated. Tenderness was appreciable on abdominal palpation while a firm, painful mass was felt in the mid-caudal abdomen. The clinical history and physical examination was suggestive of int...

  20. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    the newborn had still not passed meconium. He was transferred from the delivery hospital to our tertiary-care institution for further evaluation and management. Physical examination revealed a soft, but distended abdomen. The patient was initially managed by nil per os, nasogastric tube decompression, hyperalimentation,.

  1. Factors determining clinical outcomes in intussusception in the ...

    African Journals Online (AJOL)

    surgical exploration, and the cohort of patients in this series were not offered a second PR attempt. Absolute contraindications to PR included peritonitis, free intraperitoneal air, established obstruction, haemodynamic instability and multiorgan failure. We simultaneously instituted a prospective observational study to assess ...

  2. Chronic Ileocecal Intussusception Secondary to Non-Hodgkins ...

    African Journals Online (AJOL)

    mucoid, non-blood stained stool associated with refusal to feed and irritability. Systemic examination, an abdominal ultrasound and abdominal radiograph were non-contributory. During treatment for malnutrition and dehydration she was noted to ...

  3. Intussusception in children: Experience with 105 patients in a ...

    African Journals Online (AJOL)

    Fifty-nine per cent (62/105) were under 1 year of age, and of these 28% were receiving therapy for upper respiratory tract infection. The most common symptom ... Of the patients with unsuccessful hydrostatic reduction, 11 required intestinal resection and primary anastomosis and 35 manual reduction. Twenty-four patients ...

  4. Childhood intussusception at the Moi teaching and referral hospital ...

    African Journals Online (AJOL)

    Fullscreen Fullscreen Off. http://dx.doi.org/10.4314/eamj.v81i9.9218 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER RESOURCES... for Researchers · for Journals ...

  5. Intestinal intussusception and occlusion caused by small bowel polyps in the Peutz-Jeghers syndrome. Management by combined intraoperative enteroscopy and resection through minimal enterostomy: case report Intussuscepção intestinal e oclusão intestinal causada por pólipos em intestino delgado na síndrome Peutz-Jeghers. Tratamento com ressecção por enterotomia associado a enteroscopia intra-operatória: relato de caso

    Directory of Open Access Journals (Sweden)

    Joaquim J. Gama-Rodrigues

    2000-12-01

    Full Text Available The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyps distributed along the small intestine. Enterotomy was performed to treat only the larger polyps, therefore limiting the intestinal resection to smaller segments. The postoperative follow-up was uneventful. CONCLUSION: We point out the importance of conservative treatment for patients with this syndrome, especially those who will undergo repeated surgical interventions because of clinical manifestation while they are still young.A síndrome de Peutz-Jeghers é uma doença de caráter hereditário que freqüentemente requer intervenções endoscópicas e cirúrgicas repetidas, levando a complicações secundárias como, por exemplo, a síndrome do intestino curto. RELATO DE CASO: Relatamos neste artigo o caso de paciente de 15 anos, masculino, com história familiar para a doença, que foi submetido ao procedimento cirúrgico para tratar oclusão devido a intussucepção de intestino delgado. DISCUSSÃO: Associou-se método fibroscópico intra-operatório com a finalidade de detecção e ressecção de numerosos pólipos distribuídos em todo o intestino delgado. Realizaram-se enterotomias para a retirada dos pólipos maiores, restringindo-se, portanto, a ressecção intestinal a segmentos menores. A evolução clínica foi boa. CONCLUSÃO: Ressalta-se a importância do manejo de forma conservadora dos pacientes portadores desta síndrome, principalmente naqueles cujas manifestações clínicas de importância cirúrgica aparecem precocemente.

  6. Intussuscepção intestinal em adultos Intussusception in adults

    Directory of Open Access Journals (Sweden)

    Bernardo Hanan

    2007-12-01

    Full Text Available A intussuscepção intestinal em adultos é rara. Ao contrário do que ocorre na faixa pediátrica, é, na maioria das vezes, secundária a uma lesão definida com potencial significativo de malignidade. O objetivo deste estudo é avaliar retrospectivamente os aspectos diagnósticos e terapêuticos da intussuscepção intestinal em adultos. Foram estudados, retrospectivamente, os dados relativos às causas, à apresentação clínica, ao diagnóstico e ao manejo da doença em 16 pacientes, sendo 10 do sexo feminino (62% e com média de idade de 49 anos (variação de 19-76 anos. Os principais achados clínicos foram: dor abdominal (100%, náuseas e vômitos (62,5%, massa palpável (62,5%, distensão abdominal (37,5% e hemorragia digestiva baixa (31,25%. Sete pacientes (43,75% apresentaram quadro agudo, sendo seis por obstrução intestinal (37,5%. O diagnóstico pré-operatório foi firmado em 8 pacientes (50%, através de exame clínico associado a ultra-sonografia, tomografia computadorizada, trânsito intestinal ou colonoscopia. Todos os pacientes foram submetidos a tratamento cirúrgico. Em cinco pacientes (31,25% o segmento acometido foi o intestino delgado; em seis (37,5% o íleo terminal e a valva ileocecal e em cinco (31,25% havia acometimento colônico. Causa anatômica patológica foi identificada em 14 pacientes (87,5%, sendo que oito (50% eram portadores de neoplasias malignas. Os procedimentos de ressecção realizados foram enterectomia (18,75%, hemicolectomia direita com anastomose primária (31,25% ou ileostomia e fístula mucosa (12,5%, retossigmoidectomia a Hartmann (12,5%, retossigmoidectomia com anastomose primária (6,25% e colectomia total com anastomose íleo-retal (6,25%. Dois pacientes (12,5% foram tratados com redução sem ressecção. Complicações pós-operatórias ocorreram em 3 pacientes (seroma, abscesso de parede abdominal e arritmia cardíaca. Não houve nenhum óbito. Embora incomum, a intussuscepção deve ser suspeitada em casos de dor abdominal crônica e recorrente ou de obstrução intestinal. A ressecção está indicada na maioria dos casos devido à presença de lesão potencialmente maligna, como causa da invaginação intestinal.

  7. CLINICAL CASES OF INTESTINAL OBSTRUCTION WITH FOREIGN BODIES AND INTUSSUSCEPTION IN DOGS

    OpenAIRE

    KOIKE, Toshio; OTOMO, Kanjuro; KUDO, Tadaaki; SAKAI, Tamotsu

    1981-01-01

    The medical records of dogs treated in our veterinary hospital during a period of 15 years until 1978 were reviewed. Intestinal obstruction was diagnosed in 47 dogs, among which 51.06% were under 12 months of age and 80.85% were under 3 years. The period which elasped from the appearance of clinical signs to the operation of the obstructed intestines averaged about 5 days (ranging from 1 to 24 days). The presurgical hematological findings of 5 dogs with intestinal obstruction suggested hemoco...

  8. Inflammatory myofibroblastic tumor with ALK/TPM3 fusion presenting as ileocolic intussusception: an unusual presentation of an unusual neoplasm

    NARCIS (Netherlands)

    Milne, Anya N. A.; Sweeney, Karl J.; O'Riordain, Diarmuid S.; Pauwels, Patrick; Debiec-Rychter, Maria; Offerhaus, G. Johan A.; Jeffers, Michael

    2006-01-01

    Inflammatory myofibroblastic tumor is a rare spindle cell lesion of indeterminate malignant potential occurring in both pulmonary and extrapulmonary tissues. This report describes an unusual presentation of an unusual tumor at an unusual location: an intramural ileal case of inflammatory

  9. Perinatal Survival of a Fetus with Intestinal Volvulus and Intussusception: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Esohe Ohuoba

    2013-10-01

    Full Text Available Fetal intestinal volvulus is a rare life-threatening condition. Late diagnosis of volvulus contributes to high rate of morbidity and mortality. It has variable degrees of presentation and survival. Intrauterine volvulus may be complicated by intestinal atresia due to ischemic necrosis. To our knowledge, there are three reported cases of term fetal demise. We report a case of fetal intestinal volvulus with perinatal survival of the largest term infant described with this complication to date. The volvulus was associated with type 3A jejunal atresia and intestinal pathology was noted on prenatal ultrasound. The infant was born via urgent cesarean delivery at 376/7 weeks of gestation and underwent emergent exploratory laparotomy with resection of small bowel and primary end-to-end anastomosis. Intrauterine intestinal volvulus may be suspected on prenatal ultrasound but only definitively diagnosed postnatally. Signs of fetal distress and volvulus are rarely associated with reports of survival in the term fetus. We review reported cases of prenatally suspected volvulus in infants documented to survive past the neonatal period. As fetal volvulus and most intestinal atresias/stenoses manifest during the third trimester, we recommend that the limited fetal anatomical survey during growth ultrasounds at 32 to 36 weeks routinely include an assessment of the fetal bowel.

  10. Perinatal Survival of a Fetus with Intestinal Volvulus and Intussusception: A Case Report and Review of the Literature

    OpenAIRE

    Ohuoba, Esohe; Fruhman, Gary; Olutoye, Oluyinka; Zacharias, Nikolaos

    2013-01-01

    Fetal intestinal volvulus is a rare life-threatening condition. Late diagnosis of volvulus contributes to high rate of morbidity and mortality. It has variable degrees of presentation and survival. Intrauterine volvulus may be complicated by intestinal atresia due to ischemic necrosis. To our knowledge, there are three reported cases of term fetal demise. We report a case of fetal intestinal volvulus with perinatal survival of the largest term infant described with this complication to date. ...

  11. PAEDIATRIC SURGERY

    African Journals Online (AJOL)

    lymph nodes, a Meckel's diverticulum, polyps and duplication cysts, should be sought if an intussusception occurs outside the peak age group.1–3 Intussusceptions, in correlation with cystic fibrosis, Henoch-Schonlein purpura, haemophilia or intussusception following operative abdominal procedures, are even more rare.4 ...

  12. Recurrent small intestine intussusception in a patient with Peutz-Jeghers syndrome Invaginación recurrente del intestino delgado en un paciente con síndrome de Pentz-Jeghers

    OpenAIRE

    Orestis Ioannidis; Styliani Papaemmanouil; George Paraskevas; Anastasios Kotronis; Stavros Chatzopoulos; Athina Konstantara; Nikolaos Papadimitriou; Apostolos Makrantonakis; Emmanouil Kakoutis

    2012-01-01

    Peutz-Jeghers syndrome is a rare hereditary autosomal dominant disease caused by a mutation of the tumor suppressor gene serine/threonine kinase 11 located in chromosome 19p13.3. It is characterized by the presence of extensive mucocutaneous pigmentation, especially of the lips and the occurrence of hamartomatous polyps throughout the gastrointestinal tract. Gastrointestinal hamartomas occur predominantly in the small intestine and can become symptomatic leading usually to intestinal obstruct...

  13. Presentation and management outcome of childhood ...

    African Journals Online (AJOL)

    Background: Intussusception is the commonest cause of bowel obstruction in infancy and childhood. Early diagnosis and effective management have reduced its morbidity and mortality in developed countries. Aim: To document the presentation, management and treatment outcome of intussusceptions at the Lagos ...

  14. Download this PDF file

    African Journals Online (AJOL)

    2004-09-09

    Sep 9, 2004 ... Initial diagnosis of intussusception based on signs and symptoms was made in 6 out of 36 (17%) patients. The rest were ... part, is the commonest cause of intestinal obstruction in infancy(l,2). The typical case is a well ... Polyps were found in two of the 29(7%) patients with ileo-colic intussusception and in ...

  15. Rotavirus Immunization in Africa: A Perspective Re-visited

    African Journals Online (AJOL)

    Stringer MD, Pablot SM and Brereton RJ. Paediatric intussusception. British Journal of. Surgery 1992; 79: 867-76. 8. Murphy TV, Garguillo PM, Massoudi MS et al. Intussusception among infants given an oral rotavirus vaccine. New England Journal of Medicine 2001; 344: 564-572. 9. Simonsen L, Morens D,- Elixhauser A, ...

  16. The “Ibadan Intussusception”; now a myth? A 10 year review of adult ...

    African Journals Online (AJOL)

    Caecocolic intussusception was a significant cause of adult intestinal obstruction in Ibadan where it earned itself the appellation “Ibadan Intussusception”. Recently, it has been noticed that there is a significant drop in the cases of adult intussusception. A retrospective review of the intra-operative diagnoses of adult patients ...

  17. Vom work Book Journal, 2011 1st Edition PDF

    African Journals Online (AJOL)

    USER

    Hernia ranked highest among the surgical conditions, followed by intussusception, volvulus and rectal prolapse in that order. The intestinal conditions were more prevalent in post mortem records and in ... KEYWORDS: Hernia, Intussusception, Intestine, Large and .... patients (dogs and cats) presented intestinal volvulus ...

  18. Case series

    African Journals Online (AJOL)

    abp

    1 juin 2012 ... ... Ren- Xuan Guo, and Ke-Jian Guo. Adult intussusception: A retrospective review of 41 cases. World J Gastroenterol. 2009 Jul 14;15(26):3303-8. This article on PubMed. 14. Abou-Nukta F, Gutweiler J, Khaw J, Yavorek G. Giant lipoma causing a colo-colonic intussusception. Am Surg. 2007;73(4):417. This.

  19. Pneumatic versus hydrostatic reduction in the treatment of ...

    African Journals Online (AJOL)

    Background: The aim of this study was to compare pneumatic reduction under guidance of fluoroscopy and hydrostatic saline enema reduction under guidance of ultrasound in treatment of intussusception in pediatric patients. Methods: The study included 80 patients with intussusception in the time period from September ...

  20. A comparison of manual versus hydrostatic reduction in children ...

    African Journals Online (AJOL)

    Objective: In recent years several techniques have been recommended for intussusception treatment. In this study, an evaluation was made of intussusception cases that presented at our clinic and had reduction applied together with saline under ultrasonography (USG) and cases, which were surgically treated. Patients ...

  1. Untitled

    African Journals Online (AJOL)

    Pan-African Association of Pediatric Surgeons. (PAPSA) conference, Malawi. 2004; 3-5 May,. Guarner, J., de Leon-Bojorge, B., Lopez-Corella, E. et al. Intestinal intussusception associated with adenovirus infection in Mexican children. Amer. J. Clin, Pathol. 2003; 120:845-850,. Daneman, A. and Navarro, O. Intussusception.

  2. Gastric invagination in adults as a rare cause of constitutional syndrome.

    Science.gov (United States)

    Dávila Arias, Cristina; Milena Muñoz, Ana; Valero González, María Ángeles; Céspedes Mas, Mariano

    2017-02-01

    This article describes and illustrates the case of an adult patient with clinical symptoms of constitutional syndrome, postprandial discomfort and a mass in the left lateral abdominal region caused by a gastric intussusception with a fundal adenoma as the head of the invagination. The intussusception was diagnosed by MRI (magnetic resonance imaging).

  3. Chronic appendicitis and complete appendiceal invagination: UC, CT and MRI findings

    International Nuclear Information System (INIS)

    Diaz, Gabriel; Seehaus, Alberto; Ocantos, Jorge; Diaz, Claudia; Coccaro, Nicolas; Piccioni, Hector

    2003-01-01

    The appendiceal intussusception is a rare entity. Usually there is a predisposing factor such as a tumor, mucocele, etc. We report the case of a 61 years old female patient, with recurrent abdominal pain, localized in the right lower quadrant. We performed different diagnostic imaging exams including: double-contrast barium enema, enteroclysis, ultrasonography, computed tomography and magnetic resonance. After endoscopy a surgical procedure removed the appendix. The pathological anatomy confirmed the diagnosis of an appendiceal intussusception, complicated with a chronic inflammatory process. Appendiceal intussusception and chronic appendicitis are infrequent; it is even more uncommon the association of both entities. In addition, it was not found a predisposing cause to intussusception. For the reasons described above, we conclude that this case is an unusual presentation of appendiceal intussusception, not previously reported. (author)

  4. A classical case of Peutz–Jeghers syndrome with brief review of literature

    Directory of Open Access Journals (Sweden)

    T. Santosh

    2016-06-01

    Full Text Available PJS is an autosomal dominant genetic disease associated with melanin pigment spots on the oral mucosa, lips, nasal alae, palm and soles, as well as hamartomatous polyps in the alimentary canal. Polyps are often a cause of intussusception in the affected patients. Cancers of gastrointestinal system, uterus and breast are common in patients with PJS. Long-term follow-up is required to prevent intussusception in children and cancer in adults. We report a classical case of Peutz–Jeghers syndrome presenting with jejunoileal intussusception in a 9 year old child.

  5. 28 East and Central African Journal of Surgery Volume 12 Number 2 ...

    African Journals Online (AJOL)

    Josephine Nakato

    26.1. Table 3. Pattern of Diagnosis (n =46). CLINICAL PRESENTATION. FREQUENCY. PERCENTAGE. Appendicitis. Acute Appendicitis. Ruptured Appendicitis. Appendix Abscess. Abdominal Injury. Splenic Injury. Mesentery Injury. Intestinal Obstruction. Inguinal Hernia. Rectal Cancer. Intussusception. Sigmoid Volvulus.

  6. Rapunzel syndrome in a pediatric patient: a case report.

    Science.gov (United States)

    Middleton, Elizabeth; Macksey, Lynn Fitzgerald; Phillips, J Duncan

    2012-04-01

    This case report describes a 2.5-year-old girl who was hospitalized with complaints of abdominal pain and vomiting for 2 days. Abdominal ultrasound revealed small bowel-to-small bowel intussusception. Diagnostic laparoscopic-assisted exploration of the abdomen revealed 4 separate intestinal intussusceptions along with multiple dark intraluminal masses within the small intestine. Laparoscopic reduction of the intussusceptions was unsuccessful. Laparotomy allowed palpation of the entire small intestine with extraction of the masses, which were found to be human hair (trichobezoars). The intussusceptions were reduced, and the multiple masses were removed through a single enterotomy. The child recovered following surgery and was discharged home to her family. The surgeon counseled the parents before discharging the patient and recommended follow-up counseling for their child. The parents were given information about trichophagia and strategies to reduce the behavior in their child. A comprehensive literature review revealed this to be the youngest reported case of intussusception and Rapunzel syndrome due to trichobezoars.

  7. Accuracy of integrated total pelvic floor ultrasound compared to defaecatory MRI in females with pelvic floor defaecatory dysfunction.

    Science.gov (United States)

    Hainsworth, Alison J; Pilkington, Sophie A; Grierson, Catherine; Rutherford, Elizabeth; Schizas, Alexis M P; Nugent, Karen P; Williams, Andrew B

    2016-12-01

    Defaecatory MRI allows multicompartmental assessment of defaecatory dysfunction but is often inaccessible. Integrated total pelvic floor ultrasound (transperineal, transvaginal, endoanal) may provide a cheap, portable alternative. The accuracy of total pelvic floor ultrasound for anatomical abnormalities when compared with defaecatory MRI was assessed. The dynamic images from 68 females who had undergone integrated total pelvic floor ultrasound and defaecatory MRI between 2009 and 2015 were blindly reviewed. The following were recorded: rectocoele, enterocoele, intussusception and cystocoele. There were 26 rectocoeles on MRI (49 rectocoeles on ultrasound), 24 rectocoeles with intussusception on MRI (19 rectocoeles on ultrasound), 23 enterocoeles on MRI (24 enterocoeles on ultrasound) and 49 cystocoeles on MRI (35 cystocoeles on ultrasound). Sensitivity and specificity of total pelvic floor ultrasound were 81% and 33% for rectocoele, 60% and 91% for intussusception, 65% and 80% for enterocoele and 65% and 84% for cystocoele when compared with defaecatory MRI. This gave a negative-predictive value and positive-predictive value of 74% and 43% for rectocoele, 80% and 79% for intussusception, 82% and 63% for enterocoele and 48% and 91% for cystocoele. Integrated total pelvic floor ultrasound may serve as a screening tool for pelvic floor defaecatory dysfunction; when normal, defaecatory MRI can be avoided, as rectocoele, intussusception and enterocoele are unlikely to be present. Advances in knowledge: This is the first study to compare integrated total pelvic floor ultrasound with defaecatory MRI. The results support the use of integrated total pelvic floor ultrasound as a screening tool for defaecatory dysfunction.

  8. Complete invagination of vermiform appendix with adenocarcinoma: case report

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Young Lan; Choi, Chul Soon; Kim, Ho Chul; Bae Sang Hoon; Kim, Duck Hwan [Kang Dong Sacred Heart Hospital, Collge of Medicine, Hallym University, Seoul (Korea, Republic of)

    2000-09-01

    Appendiceal intussusception is a very rare pathological condition, an incidence, as revealed by appendectomy specimens, of only 0.01 percent. There are various types among which complete invagination of the appendix is very rare. We encountered a case of intussusception of the appendix with complete invagination induced by appendiceal adenocarcinoma. A preoperative diagnosis of appendiceal adenocarcinoma and intussusception was not possible, but a final pathological report confirmed these conditions and retrospective analysis of a barium enema showed a finger-like filling defect of the cecum, a relatively specific finding in such cases. We describe a case involving a 39-year old man who one month earlier had noted the onset of pain in the right lower abdomen. (author)

  9. Small bowel obstruction due to inflammatory fibroid polyp.

    Science.gov (United States)

    Das, S; Mandal, T S; Sinhababu, A K; Chatterjee, T K; Khamrui, T K; Bhattacharya, H

    2012-01-01

    Inflammatory fibroid polyp is a benign and non-neoplastic condition of the intestinal tract, commonly affecting the gastric antrum, though it can affect any part of the gastro-intestinal tract. It is a submucosal, sessile, poypoid mass composed of myofibroblast like mesenchymal cells, numerous small blood vessels and marked inflammatory cell infiltrate mainly eosinophils. It commonly presents as intestinal obstruction or intussusception. A case of recurrent partial small intestinal obstruction due to intermittent intussusception associated with inflammatory fibroid polyp of jejunum is being reported.

  10. Gastritis Cystica Polyposa with Gastroduodenal Intussuception: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Soon Hyuk; Bae, Il Hun; Park, Kil Sun; Lee, Seung Young; Jeon, Min Hee; Cho, Bum Sang; Kamg, Min Ho [Dept. of Radilogy, College of Medicine and Medical Research Institute, Chonbuk National University, Chonju (Korea, Republic of); Ryu, Dong Hee [Dept. of Surergy, College of Medicine and Medical Research Institute, Chonbuk National University, Chonju (Korea, Republic of); Lee, Ho Chang [Dept. of Pathology, College of Medicine and Medical Research Institute, Chonbuk National University, Chonju (Korea, Republic of)

    2011-04-15

    Gastritis cystica polyposa is an uncommon benign lesion that normally occurs on the gastric side of a gastroenterostomy site but is rarely found in patients without a prior history of stomach surgery. We report a case of a 41-year-old woman with gastrodeuodenal intussusception due to gastritis cystica polyposa that developed in an unoperated stomach. CT revealed gastroduodenal intussusception and a cystic and solid mass with fat density in the second portion of the duodenum. Surgery and a pathologic examination confirmed gastritis cystica polyposa.

  11. Gastritis Cystica Polyposa with Gastroduodenal Intussuception: A Case Report

    International Nuclear Information System (INIS)

    Kwak, Soon Hyuk; Bae, Il Hun; Park, Kil Sun; Lee, Seung Young; Jeon, Min Hee; Cho, Bum Sang; Kamg, Min Ho; Ryu, Dong Hee; Lee, Ho Chang

    2011-01-01

    Gastritis cystica polyposa is an uncommon benign lesion that normally occurs on the gastric side of a gastroenterostomy site but is rarely found in patients without a prior history of stomach surgery. We report a case of a 41-year-old woman with gastrodeuodenal intussusception due to gastritis cystica polyposa that developed in an unoperated stomach. CT revealed gastroduodenal intussusception and a cystic and solid mass with fat density in the second portion of the duodenum. Surgery and a pathologic examination confirmed gastritis cystica polyposa.

  12. A 16-Year-Old Female with Peutz-Jeghers Syndrome

    Directory of Open Access Journals (Sweden)

    Mufti Munsurar Rahman

    2014-09-01

    Full Text Available Peutz-Jeghers syndrome is a rare autosomal dominant disorder of hamartomatous polyposis of the gastrointestinal tract, with pigmentation around lips and macules on the buccal mucosa that typically manifests itself as recurrent colicky abdominal pain and intestinal obstruction due to intussusception. Here we report a case of a 16-year-old girl who presented with abdominal pain, vomiting and previous history of laparotomy for intussusception. Multiple well demarcated black pigmented macules on lips, perioral region, buccal mucosa, digits, palms and soles were noted. She was diagnosed as a case of Peutz-Jeghers syndrome and managed conservatively.

  13. Sudan Journal of Medical Sciences - Vol 3, No 4 (2008)

    African Journals Online (AJOL)

    Acute intussusception in children seen at El Obeid Hospital, Western Sudan. EMAIL FULL TEXT EMAIL FULL TEXT ... Incidence of ventricular arrhythmias, brady-arrhythmias and sudden cardiac death in Sudanese Patients with acute Myocardial Infarction · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT ...

  14. Provisional PDF Published 14 March 2010 Case report, Volume 4 ...

    African Journals Online (AJOL)

    cqq1a

    2010-03-14

    Mar 14, 2010 ... to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults. ... of cases. These causes include malignant process, lipomas and polyps as well as oedema and fibrosis from recent or previous surgery. Authors ...

  15. Obstructive right paraduodenal hernia: A case report

    African Journals Online (AJOL)

    sigmoid volvuli, strangulated hernias, intussusception and in children, congenital gut malformations. Paraduodenal hernia causing intestinal obstruction has not been encountered in our practice. Case. A twelve year old patient presented with a one day history of abdominal distention, worsening colicky abdominal pain ...

  16. Prolapsed gastric mucosa through gastrojejunostomy (Report of 3 cases with review of the literature)

    International Nuclear Information System (INIS)

    Kim, Jong Deok

    1984-01-01

    The radiologic findings of prolapsed gastric mucosa through gastrojejunostomy stoma after gastrectomy is very characteristic, but recurrent gastric cancer, retrograde jejunogastric intussusception, and Hofmeister defect should be differentiated from it because of their similar postoperative upper gastrointestinal series findings. The author reports 3 cases of prolapsed gastric mucosa through gastrojejunostomy stoma after Hofmeister's gastrectomy with brief review of the literature

  17. Rare cause of intestinal obstruction, Ascaris lumbricoides infestation: two case reports

    Science.gov (United States)

    Yetim, Ibrahim; Semerci, Ersan; Abanoz, Recep

    2009-01-01

    Ascaris lumbricoides is common resident of intestine especially low socioeconomic areas in the world. Complication of Ascaris lumbricoides has been reported include obstruction of the small intestine, intestinal volvulus and intussusception. We report two children with severe sequelae of intestinal obstruction. PMID:19830032

  18. Rare cause of intestinal obstruction, Ascaris lumbricoides infestation: two case reports

    OpenAIRE

    Yetim, Ibrahim; Ozkan, Orhan Veli; Semerci, Ersan; Abanoz, Recep

    2009-01-01

    Ascaris lumbricoides is common resident of intestine especially low socioeconomic areas in the world. Complication of Ascaris lumbricoides has been reported include obstruction of the small intestine, intestinal volvulus and intussusception. We report two children with severe sequelae of intestinal obstruction.

  19. Author Details

    African Journals Online (AJOL)

    Al-Selwi, AHA. Vol 7, No 2 (2012) - Articles Peutz Jeghers Syndrome presented as intermittent gastric outlet obstruction and ileoileal intussusceptions. Abstract. ISSN: 1858-5051. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

  20. Can the modified Tan–Bianchi circumumbilical approach be used ...

    African Journals Online (AJOL)

    (b, c) The relaxing midline incisions ( dotted lines). (d, e) Umbilicoplasty with excision of the four dog ears B, B0, D, D0, making the umbilicus a whole circle. Table 2 Indication for surgery and operative procedure. Indication. Number of cases. Operative procedure. Intussusception. 13. Resection and anastomosis. (n = 7).

  1. ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 55

    African Journals Online (AJOL)

    Hp 630 Dual Core

    (n 18) in patients with gangrenous bowel, manual reduction (n 12) and resection and primary anastomosis (n 3) in patients with viable bowel, and resection and anastomosis (n 7) in all patients with bowel perforation. The site of intussusception was ileo ileal in 2 (4.4%) cases, ileo ceacal in 7 (15.6%) cases, ileo colonic in 23 ...

  2. Meckel's diverticulum in paediatric practice on Crete (Greece): A 10 ...

    African Journals Online (AJOL)

    Nine patients (19.9%) had clinical features of peritonitis; of these, three had perforated MD and six had Meckel's diverticulitis at laparotomy. Four patients were diagnosed with intestinal obstruction. Seven patients (15.5%) presented with lower gastrointestinal bleeding. Ultrasound scans revealed intussusception in three ...

  3. East African Medical Journal Vol. 81 No. 9 September 2004

    African Journals Online (AJOL)

    Population and Housing Census 2002 Vol. 2, Age and Sex distribution. Central Census Office, National Bureau of. Statistics, President's Office, Planning and Privatisation. Published September 2003, pg 125. 10. Shija, J.K. Childhood intussusception in Dares-Salaam. The proceedings of the Association of Surgeons of East.

  4. Appendiceal Endometriosis: A case Report and Literature Review ...

    African Journals Online (AJOL)

    Appendiceal endometriosis is a very rare and usually asymptomatic condiction, but can result in severe complications such as intestinal perforation, massive gastrointestinal bleeding or intussusception. We report a case of endometriosis of the appendix presenting as acute appendicitis. The patient was a 36 year old ...

  5. Laparoscopic right hemicolectomy for intestinal intussuception.

    LENUS (Irish Health Repository)

    Kiernan, F

    2012-09-01

    Adult intussusception is rare and usually associated with carcinoma in 50% of the cases. These have traditionally been managed using an open technique. We herein describe a laparoscopic extended right hemicolectomy in a 62-year-old lady with an intussuception secondary to a transverse colonic tumor.

  6. 78 FR 44512 - National Vaccine Injury Compensation Program

    Science.gov (United States)

    2013-07-24

    ... African study had no cases of intussusception in either vaccine or placebo groups, and the Asian study had... demonstrated by clinical signs and symptoms and need not be confirmed by culture or serologic testing. Cases of...), which may be demonstrated by clinical signs and symptoms and need not be confirmed by culture or...

  7. SAJS 970 - Paediatric Surgery.indd

    African Journals Online (AJOL)

    The treatment modality of choice was barium enema in 75 patients (71.4%), and this was successful in 36. Twenty-six (70%) of these patients were under 1 year of age. Hydrostatic barium enema reduction failed in 39 of 75 patients, and in 30 of them reduction could be achieved manually. Re-intussusception developed in 2 ...

  8. Henoch-Schönlein purpura in children: Limited benefit of corticosteroids

    OpenAIRE

    Bluman, Joel; Goldman, Ran D.

    2014-01-01

    Question A child recently presented to my office with lower limb petechiae, arthralgia, and abdominal pain characteristic of Henoch-Schönlein purpura (HSP). Will systemic corticosteroids help relieve these symptoms and prevent potential HSP complications such as intussusception and nephritis?

  9. role of abdominal ultrasound in evaluation of children

    African Journals Online (AJOL)

    2011-03-16

    Mar 16, 2011 ... ROLE OF ABDOMINAL ULTRASOUND IMAGING IN EVALUATION OF CHILDREN WITH SUSPECTED UPPER. GASTROINTESTINAL ... of US in the diagnosis of HPS. The typically thickened pyloric muscle measures > ..... Colour Doppler assessment of the intussusception cases detected blood flow in 10 ...

  10. CASE REPORT

    African Journals Online (AJOL)

    DR ABDUL

    perinatal death of the second twin and severe anaemia. As intestinal obstruction is a rare but serious event in pregnancy, the importance of high index of suspicion in the evaluation of ... impression of intestinal obstruction in pregnancy probably due to intussusception was made with differentials of appendiceal mass and ...

  11. Browse Title Index

    African Journals Online (AJOL)

    Items 351 - 400 of 488 ... Vol 8, No 2 (2011), Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience, Abstract. Y Boateng Mensah, H Glover-Addy, V Etwire, MB Twum, S Asiamah, W Appeadu-Mensah, AAJ Hesse. Vol 3, No 1 (2006), Post Polio Paralysis: A Clarion Call For ...

  12. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 250 of 488 ... Vol 4, No 2 (2007), Hydrostatic Reduction of Intussusception under Ultrasound Guidance: An Initial Experience in a Developing Country, Abstract. O M Atalabi, O O Ogundoyin, D I Ogunlana, O M Onasanya, T A Lawal, A S Olarinoye. Vol 8, No 3 (2011), Hypospadias in Sudan, clinical and surgical ...

  13. Author Details

    African Journals Online (AJOL)

    Saied, Basem. Vol 13, No 4 (2017) - Articles Pneumatic versus hydrostatic reduction in the treatment of intussusception in children. Abstract PDF. ISSN: 1687-4137. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

  14. African Journal of Paediatric Surgery - Vol 4, No 2 (2007)

    African Journals Online (AJOL)

    Hydrostatic Reduction of Intussusception under Ultrasound Guidance: An Initial Experience in a Developing Country · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. O M Atalabi, O O Ogundoyin, D I Ogunlana, O M Onasanya, T A Lawal, A S Olarinoye, 68-71 ...

  15. Author Details

    African Journals Online (AJOL)

    Olofinlade, O.O.. Vol 8, No 1 (2016) - Articles Hydrostatic reduction of intussusception with normal saline using the gravity aided method in a Nigerian teaching hospital. Abstract. ISSN: 2141-1123. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

  16. Author Details

    African Journals Online (AJOL)

    Karakas, E. Vol 11, No 2 (2014) - Articles A comparison of manual versus hydrostatic reduction in children with intussusception: Single-center experience. Abstract. ISSN: 0189-6725. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

  17. Nigerian Journal of Clinical Medicine - Vol 8, No 1 (2016)

    African Journals Online (AJOL)

    Hydrostatic reduction of intussusception with normal saline using the gravity aided method in a Nigerian teaching hospital · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. M.A. Abdulsalam, B.O. Balogun, R.I. Osuoji, O.O. Olofinlade, O.M. Faboya, M.A. Bankole, 25-32 ...

  18. Author Details

    African Journals Online (AJOL)

    Mir, IN. Vol 54, No 1 (2016) - Articles An experience of ultrasound-guided hydrostatic reduction of intussusception at a tertiary care centre. Abstract PDF. ISSN: 2078-5151. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

  19. Author Details

    African Journals Online (AJOL)

    Ogundoyin, O O. Vol 4, No 2 (2007) - Articles Hydrostatic Reduction of Intussusception under Ultrasound Guidance: An Initial Experience in a Developing Country Abstract. ISSN: 0189-6725. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  20. Author Details

    African Journals Online (AJOL)

    Onasanya, O M. Vol 4, No 2 (2007) - Articles Hydrostatic Reduction of Intussusception under Ultrasound Guidance: An Initial Experience in a Developing Country Abstract. ISSN: 0189-6725. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  1. Author Details

    African Journals Online (AJOL)

    Ogunlana, D I. Vol 4, No 2 (2007) - Articles Hydrostatic Reduction of Intussusception under Ultrasound Guidance: An Initial Experience in a Developing Country Abstract. ISSN: 0189-6725. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  2. WITH CHRONIC ANAEMIA: A CASE REPORT

    African Journals Online (AJOL)

    A working diagnosis of traverse colonic neoplasm was made. Abdominal ultrasonography showed a roundish ... function tests were normal. Stool microscopy showed red blood cells of. 4-5/hpf; no ova or cysts were seen ... parasites or diverticular disease. For this reason, adult intussusception should be resected, but this is.

  3. Author Details

    African Journals Online (AJOL)

    Obiora, EU. Vol 11, No 3 (2014) - Articles Transanal protrusion of intussusceptions in children. Abstract. ISSN: 0189-6725. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News.

  4. Case report

    African Journals Online (AJOL)

    cqq1a

    2010-10-21

    Oct 21, 2010 ... Mucocele can also occur due to occlusion of the lumen by endometriosis or carcinoid tumour. The clinical presentation of ... intussusception or endometriosis. An intra-abdominal mass is palpated by the ... there is evidence of malignancy such as peritoneal deposits [9]. Some suggest that a frozen-section ...

  5. Haematemesis: a new syndrome?

    Science.gov (United States)

    Axon, A T; Clarke, A

    1975-01-01

    Three patients presented with symptoms suggesting a Mallory-Weiss tear. Endoscopy showed a localized, clearly demarcated area of bright red mucosa near the gastro-oesophageal junction; this was thought to have arisen by retrograde intussusception of the stomach during vomiting or retching and may have caused the haemorrhage. PMID:1079153

  6. ISSN 2073-9990 East Cent Afr J Surg

    African Journals Online (AJOL)

    as an appendectomy or several episodes of pelvic inflammatory disease. The remaining documented causes of intestinal obstruction in pregnancy listed in descending frequency are volvulus (24%), intussusception (5%) and ileosigmoid knotting (3.2% to 5.9%).1,2,4,5. Ileosigmoid knotting (ISK), also known as compound ...

  7. Research

    African Journals Online (AJOL)

    abp

    2016-05-10

    May 10, 2016 ... 34.5%) and resection and stoma (1, 3.4%). The median duration of stay was 6 days (range 1-25). Ascariasis was the most common cause of IO in .... intussusceptions at a tertiary care hospital in northwestern. Tanzania: a diagnostic and therapeutic challenge in resource- limited setting. Ital. J. Pediatr. 2014;.

  8. Blue rubber bleb nevus syndrome coexisted with intestinal ...

    African Journals Online (AJOL)

    Blue Rubber Bleb Nevus Syndrome (BRBNS) is an uncommon congenital disorder characterized by sporadic venous malformation which mainly occurs in skin and alimentary canal. Here, we report a BRBNS patient with concomitant intestinal intussusception who diagnosed by intraoperative endoscopy and ultimately ...

  9. Gastrointestinal Kaposi Sarcoma Presenting In A Nigeria African ...

    African Journals Online (AJOL)

    Adult intussusception is a rare condition that is seen once in a while in surgical practice, 1. In this report we the case of a thirty –five year old Nigeria male on medical treatment of earlier diagnosed AIDS who had no evidence of cutaneous Kaposi sarcoma. He later presented with a palpable right lower quadrant mass and ...

  10. Diagnostic value of ultrasonography in evaluation and management ...

    African Journals Online (AJOL)

    Results: Common causes of acute abdominal emergencies in pediatric patients as noted on ultrasonography included nonspecifi c pain (28%), abdominal abscess (21%), acute appendicitis (7%) and intussusception (7%). Ultrasonography was diagnostic in 45.2% cases and supportive in 12.3% of the cases. As for as the fi ...

  11. Prenatal Ultrasonographic Diagnosis Of Congenital Multiple Ileal ...

    African Journals Online (AJOL)

    Ileal atresia is an uncommon congenital lesion that results from intra-uterine ischemia and less commonly, from in-utero obstruction like intussusception, malrotation and internal hernia. Multiple atresias are less common and are usually diagnosed within the first 24 hours of life. The age at presentation is one to thirty days.

  12. A single-institution experience with hydrostatic reduction for ...

    African Journals Online (AJOL)

    Background/purpose Hydrostatic reduction for intussusception has the benefit of achieving reduction without the need for general anaesthesia or surgery and the possible attendant complications. This has made it the most popular interventional modality in many centres today. Hydrostatic reduction was added to our ...

  13. Mesenteric venous thrombosis in Uganda: a retrospective study of ...

    African Journals Online (AJOL)

    Introduction: Mesenteric venous thrombosis is a rare but lethal form of mesenteric ischemia. Diagnosis before frank thrombosis and gangrene is a challenge. Documented experience in the East African region is scanty. This short series suggest renal dysfunction as a consequence of delayed diagnosis, intussusception as a ...

  14. Surgical Complications of Hemorrhagic Vasculitis in a Child

    Directory of Open Access Journals (Sweden)

    E. Y. Dyakonova

    2015-01-01

    Full Text Available Hemorrhagic vasculitis is a hematological disorder, which is often accompanied by abdominal pain syndrome and blood in stool, which is why it requires differential diagnosis with acute surgical pathology. The article presents clinical follow-up of a patient with hemorrhagic vasculitis complicated by intestinal intussusception and developed mesenteric thrombosis, which required emergency surgical intervention. 

  15. Author Details

    African Journals Online (AJOL)

    Perry, Paul A. Vol 12, No 4 (2016) - Articles Meckel's diverticulum: the lead point of intrauterine intussusception with subsequent intestinal atresia in a newborn. Abstract PDF. ISSN: 1687-4137. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

  16. EAMJ Nov. Pneumatic.indd

    African Journals Online (AJOL)

    2008-11-11

    Nov 11, 2008 ... Abdominal ultrasound showing a 'doughnut-like mass' in the transverse plane and a “pseudokidney” in the longitudinal plane, with thick walls and invaginated bowel loops in an ileo-colic intussusception ... cause of strangulation-occlusion type of intestinal obstruction in childhood and remains a significant.

  17. Value of post-licensure data on benefits and risks of vaccination to inform vaccine policy: The example of rotavirus vaccines.

    Science.gov (United States)

    Parashar, Umesh D; Cortese, Margaret M; Payne, Daniel C; Lopman, Benjamin; Yen, Catherine; Tate, Jacqueline E

    2015-11-27

    In 1999, the first rhesus-human reassortant rotavirus vaccine licensed in the United States was withdrawn within a year of its introduction after it was linked with intussusception at a rate of ∼1 excess case per 10,000 vaccinated infants. While clinical trials of 60,000-70,000 infants of each of the two current live oral rotavirus vaccines, RotaTeq (RV5) and Rotarix (RV1), did not find an association with intussusception, post-licensure studies have documented a risk in several high and middle income countries, at a rate of ∼1-6 excess cases per 100,000 vaccinated infants. However, considering this low risk against the large health benefits of vaccination that have been observed in many countries, including in countries with a documented vaccine-associated intussusception risk, policy makers and health organizations around the world continue to support the routine use of RV1 and RV5 in national infant immunization programs. Because the risk and benefit data from affluent settings may not be directly applicable to developing countries, further characterization of any associated intussusception risk following rotavirus vaccination as well as the health benefits of vaccination is desirable for low income settings. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Ltd.. All rights reserved.

  18. Clinical and Genetic Analysis of Peutz-Jeghers Syndrome Patients in Taiwan

    Directory of Open Access Journals (Sweden)

    Meng-Tzu Weng

    2010-05-01

    Conclusion: Compared with other countries, PJS patients in Taiwan tended to have more extensive polyps in the gastrointestinal tract, with intussusception being the most common abdominal symptom. Mutations in the LKB1 gene were identified in 57% of the probands in Taiwan.

  19. Gastrointestinal Polyps in Children

    Directory of Open Access Journals (Sweden)

    Li-Chun Wang

    2009-10-01

    Conclusion: Gastrointestinal polyps in children are usually benign. Pediatricians treating a child with a gastrointestinal polyp should pay attention to the immediate complications of the polyps, such as intussusception or bleeding, the extraintestinal manifestations and long-term risk for malignancy.

  20. Author Details

    African Journals Online (AJOL)

    Kale, N. Vol 50, No 2 (2012) - Articles Intussusception in children: Experience with 105 patients in a department of paediatric surgery, Turkey Abstract PDF. ISSN: 2078-5151. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

  1. A rare cause of coffee-ground vomiting: Retrograde jejunogastric ...

    African Journals Online (AJOL)

    Retrograde jejunogastric intussusception is a well-recognised, rare, but potentially fatal long-term complication of gastrojejunostomy or Billroth II reconstruction. Only about 200 cases have been reported in the literature to date. Diagnosis of this condition is difficult in most cases. To avoid mortality, earlydiagnosis and prompt ...

  2. South African Journal of Surgery - Vol 50, No 2 (2012)

    African Journals Online (AJOL)

    Intussusception in children: Experience with 105 patients in a department of paediatric surgery, Turkey · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. K Sonmez, Z Turkyilmaz, B Demirogullari, R Karabulut, N Kale, A Can Basaklar ...

  3. African Journal of Paediatric Surgery - Vol 3, No 1 (2006)

    African Journals Online (AJOL)

    Acute Intussusception in childhood: Aspects of epidemiologic, Clinical Features and Management at Children's Hospital, Donka, Guinea Conakry · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. M Keita, O T Barry, N Doumbouya, A F Diallo, B M Toure, I Balde, 1-3 ...

  4. Surgical complications of Meckel\\'s diverticulae: a review of seven ...

    African Journals Online (AJOL)

    Out of the seven cases of Meckel\\'s diverticulae, six presented as surgical emergencies. There were three cases of diverticulitis, two of intestinal obstruction due to bands, and one case formed the apex of an intussusception, which presented as an appendix mass. There were no cases of gastro-intestinal bleeding, fistulae, ...

  5. Download this PDF file

    African Journals Online (AJOL)

    GB

    Gangrenous sigmoid. 6. 46.2. Colorectal cancer. 3. 23.1. Anorectal cancer. 1. 7.7. Ileosigmoid knotting. 1. 7.7. Penetrating abdominal injury. 1. 7.7. Intussusceptions. 1. 7.7. Total. 13 62.0%. Myocardial infarctions. Gangrenous sigmoid. 2. 66.7. Fournier's gangrene. 1. 33.3. Total. 3. 14.3. Respiratory failure. Colorectal cancer.

  6. GENERAL SURGERY

    African Journals Online (AJOL)

    Cruveilhier J. Anatomie pathologique du corps humain. Paris: JB Balliere, 1835. 3. Goldman RL. Hamartomatous polyp of Brunner's gland. Gastroenterology. 1963;44:57-62. 4. Kellogg EL. Intussusception of the duodenum caused by adenoma originating in Brunner's glands. Med J Record. 1931;134:440-2. 5. Lempke RE.

  7. Download this PDF file

    African Journals Online (AJOL)

    GB

    This is partly due to the fact that it is usually very difficult to differentiate benign from malignant causes in enteric intussusceptions non-operatively. (7). Other relatively rare causes like lipoma (5) and even parasitic infestation have been demonstrated by Yersinia enterocolitica (2). In our first case following Caesarean section, ...

  8. Rectal Prolapse Associated with Constipation in a Curly Colt (Case ...

    African Journals Online (AJOL)

    However, it must be differentiated from prolapsed ileo-ceco colic intussusceptions by passing a probe, blunt instrument, or finger between the prolapsed mass and the inner rectal wall. In rectal prolapse, the instrument cannot be inserted due to the presence of a fornix Cynthia, (2005), this is very important in differentiating ...

  9. Integrated total pelvic floor ultrasound in pelvic floor defaecatory dysfunction.

    Science.gov (United States)

    Hainsworth, A J; Solanki, D; Hamad, A; Morris, S J; Schizas, A M P; Williams, A B

    2017-01-01

    Imaging for pelvic floor defaecatory dysfunction includes defaecation proctography. Integrated total pelvic floor ultrasound (transvaginal, transperineal, endoanal) may be an alternative. This study assesses ultrasound accuracy for the detection of rectocele, intussusception, enterocele and dyssynergy compared with defaecation proctography, and determines if ultrasound can predict symptoms and findings on proctography. Treatment is examined. Images of 323 women who underwent integrated total pelvic floor ultrasound and defaecation proctography between 2011 and 2014 were blindly reviewed. The size and grade of rectocele, enterocele, intussusception and dyssynergy were noted on both, using proctography as the gold standard. Barium trapping in a rectocele or a functionally significant enterocele was noted on proctography. Demographics and Obstructive Defaecation Symptom scores were collated. The positive predictive value of ultrasound was 73% for rectocele, 79% for intussusception and 91% for enterocele. The negative predictive value for dyssynergy was 99%. Agreement was moderate for rectocele and intussusception, good for enterocele and fair for dyssynergy. The majority of rectoceles that required surgery (59/61) and caused barium trapping (85/89) were detected on ultrasound. A rectocele seen on both transvaginal and transperineal scanning was more likely to require surgery than if seen with only one mode (P = 0.0001). If there was intussusception on ultrasound the patient was more likely to have surgery (P = 0.03). An enterocele visualized on ultrasound was likely to be functionally significant on proctography (P = 0.02). There was, however, no association between findings on imaging and symptoms. Integrated total pelvic floor ultrasound provides a useful screening tool for women with defaecatory dysfunction such that defaecatory imaging can avoided in some. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  10. Removing the age restrictions for rotavirus vaccination: a benefit-risk modeling analysis.

    Directory of Open Access Journals (Sweden)

    Manish M Patel

    Full Text Available BACKGROUND: To minimize potential risk of intussusception, the World Health Organization (WHO recommended in 2009 that rotavirus immunization should be initiated by age 15 weeks and completed before 32 weeks. These restrictions could adversely impact vaccination coverage and thereby its health impact, particularly in developing countries where delays in vaccination often occur. METHODS AND FINDINGS: We conducted a modeling study to estimate the number of rotavirus deaths prevented and the number of intussusception deaths caused by vaccination when administered on the restricted schedule versus an unrestricted schedule whereby rotavirus vaccine would be administered with DTP vaccine up to age 3 years. Countries were grouped on the basis of child mortality rates, using WHO data. Inputs were estimates of WHO rotavirus mortality by week of age from a recent study, intussusception mortality based on a literature review, predicted vaccination rates by week of age from USAID Demographic and Health Surveys, the United Nations Children's Fund (UNICEF Multiple Indicator Cluster Surveys (MICS, and WHO-UNICEF 2010 country-specific coverage estimates, and published estimates of vaccine efficacy and vaccine-associated intussusception risk. On the basis of the error estimates and distributions for model inputs, we conducted 2,000 simulations to obtain median estimates of deaths averted and caused as well as the uncertainty ranges, defined as the 5th-95th percentile, to provide an indication of the uncertainty in the estimates. We estimated that in low and low-middle income countries a restricted schedule would prevent 155,800 rotavirus deaths (5th-95th centiles, 83,300-217,700 while causing potentially 253 intussusception deaths (76-689. In contrast, vaccination without age restrictions would prevent 203,000 rotavirus deaths (102,000-281,500 while potentially causing 547 intussusception deaths (237-1,160. Thus, removing the age restrictions would avert an

  11. Imagenological behaviour in view of intestinal invagination in children under two years of age

    International Nuclear Information System (INIS)

    Morffi Gonzalez, Barbara Evelyn; Gonzalez Coba, Maria Isabel; Quintas Santana, Maria; Lopez Gonzalez, Saray Maria

    2010-01-01

    We performed an observational study with the aim of imaging to determine the behavior of intussusception in children under 2 years at the Provincial Teaching Hospital, Dr. Antonio Luaces Iraola 'Ciego de Avila', in the time period from January 1, 2006 to January 1, 2009. The sample consisted of 18 patients under 2 years with clinical and imaging diagnosis of intussusception treated at the Imaging department. Predominant age group younger than 4 months and the male was predominant topographic presentation ileocolic and idiopathic, ultrasound and radiographic examination was performed at 100% of the patients demonstrated decreased intestinal gas pattern as a dominant sign in simple test, the arrest of Contrast 'crab claws' in the colon by enema and the sign of the 'target' or 'pseudo kidney' in the abdominal ultrasonography, there were 12 surgical and 6 reductions reductions permanent imaging, 4 hydro colonic, with a recurrence and 2 for barium enema

  12. Gastrointestinal radiation syndrome in dogs irradiated with 10 Gy 60Co γ-rays

    International Nuclear Information System (INIS)

    Mao Bingzhi; Chen Dezheng; Zhu Xinhua

    1985-01-01

    The clinical features of gastrointestinal radiation syndrome induced by 10 Gy 60 Co γ-ray irradiation were studied in 9 dogs. The GI-syndrome ran a very critically ill and fast developing course, ending in early death. All dogs died within 3-6 days after irradiation with very severe gastrointestinal symptoms: frequent vomiting, severe diarrhea (bloody liquid stool), early loss of appetite, dehydration and electrolyte disorder. Hematopoietic injury was more severe than that in hematopoietic radiation syndrome. Intussusception occurred in 3 of 9 dogs (33.3%). The distinction between the different stages of clinical course was rather obscure. Dehydration and electrolyte disorder, intoxication, intussusception, adrenal hemorrhage and cardiac failure were the main causes of death

  13. New approaches in oral rotavirus vaccines.

    Science.gov (United States)

    Kuate Defo, Zenas; Lee, Byong

    2016-05-01

    Rotavirus is the leading cause of severe dehydrating diarrhea worldwide, and affects primarily developing nations, in large part because of the inaccessibility of vaccines and high rates of mortality present therein. At present, there exist two oral rotaviral vaccines, Rotarix™ and RotaTeq™. These vaccines are generally effective in their actions: however, associated costs often stymie their effectiveness, and they continue to be associated with a slight risk of intussusception. While different programs are being implemented worldwide to enhance vaccine distribution and monitor vaccine administration for possible intussusception in light of recent WHO recommendation, another major problem persists: that of the reduced efficacy of the existing rotaviral vaccines in developing countries over time. The development of new oral rotavirus vaccine classes - live-attenuated vaccines, virus-like particles, lactic acid bacteria-containing vaccines, combination therapy with immunoglobulins, and biodegradable polymer-encapsulated vaccines - could potentially circumvent these problems.

  14. Ascaris Lumbricoides infestation and intestinal MZBCL: a surgical and radiological perspective.

    Science.gov (United States)

    Assenza, M; Casciani, E; Romeo, V; Valesini, L; Centonze, L; Bartolucci, P; Ciccarone, F; Gualdi, G; Modini, C

    2011-01-01

    Ascaris Lumbricoides is the most common worm found in human beings and it is the largest of the intestinal nematodes parasitizing humanity. The most common complication of Ascariasis is mechanical bowel obstruction caused by a large number of worms. Bowel obstruction can also be caused by various toxins released by the worms. A large worm bolus can also cause volvulus or intussusception. We report a case of Intestinal Obstruction due to an Ileal MZBCL in an Ascaris. Lumbricoides infestation setting.

  15. Radiological features of Meckel's diverticulum and its complications

    Energy Technology Data Exchange (ETDEWEB)

    Thurley, P.D. [Departments of Radiology Queens Medical Centre, Nottingham University Hospitals, Nottingham (United Kingdom)], E-mail: pthurley@doctors.org.uk; Halliday, K.E.; Somers, J.M. [Departments of Radiology Queens Medical Centre, Nottingham University Hospitals, Nottingham (United Kingdom); Al-Daraji, W.I.; Ilyas, M. [Histopathology, Queens Medical Centre, Nottingham University Hospitals, Nottingham (United Kingdom); Broderick, N.J. [Departments of Radiology Queens Medical Centre, Nottingham University Hospitals, Nottingham (United Kingdom)

    2009-02-15

    Meckel's diverticulum is the most common congenital abnormality of the small bowel. The majority of patients with this anomaly will remain asymptomatic; however, several complications may occur, including obstruction, intussusception, perforation, diverticulitis, and gastrointestinal haemorrhage. These complications may produce a variety of different clinical features and radiological appearances. The purpose of this article is to review the potential imaging manifestations of Meckel's diverticulum and its complications and discuss the advantages and disadvantages of the imaging techniques available.

  16. Intraluminal duodenal diverticulum: CT and gadoxetic acid-enhanced MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Myeong; Lee, Nam Kyung; Kim, Suk; Kim, Dong Uk; Kim, Tae Un [Dept. of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2015-03-15

    Intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly. IDD can become symptomatic in 20% to 25% of cases when complicated by intestinal obstruction, pancreatitis, or hemorrhage. We report the case of a 21-year-old female presenting with IDD mimicking duodenoduodenal intussusception. We describe the imaging features of IDD on the gadoxetic acid-enhanced magnetic resonance image as well as computed tomography.

  17. [Strangled rectal prolapse in young adults: about a case and review of the literature].

    Science.gov (United States)

    Bayar, Rached; Djebbi, Achref; Mzoughi, Zeineb; Talbi, Ghofrane; Gharbi, Lassaad; Arfa, Nafaa; Mestiri, Hafedh; Khalfallah, Mohamed Taher

    2016-01-01

    Rectal prolapse is a rectal static disorder which involves rectal wall intussusception inducing its externalization through the anus. It usually affects children and the elderly. Its occurrence in young adults is rare. Strangulated rectal prolapse is also a rare complication. We report the case of a 30-year old patient who underwent emergency surgery for strangulated rectal prolapse. Emergency perineal rectosigmoidectomy (Altemeier repair) was performed with simple outcome.

  18. Imaging Findings of the Unusual Presentations, Associations and Clinical Mimics of Acute Appendicitis

    OpenAIRE

    Demir, Mustafa Kemal; Savas, Yildiray; Furuncuoglu, Yavuz; Cevher, Tarik; Demiral, Serdar; Tabandeh, Babek; Aslan, Melisa

    2017-01-01

    There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastroint...

  19. Internet Journal of Medical Update

    African Journals Online (AJOL)

    admin

    case report. Acta Chir Belg. 2006 Mar-. Apr;106(2):228-9. 2. Sarin YK, Pathak D. Torsion of. Vermiform Appendix. Ind Pediatr. 2006;43:266-267. 3. Baeza-Herrera C, Garcia-Cabello LH,. Leon-Cruz A, et al. Torsion of the vermiform appendix associated with intussusception. Cir Cir. 2006 Sep-. Oct;74(5)369-71. 4. Payne JE.

  20. ROTAVIRUS VACCINES

    OpenAIRE

    Kang, G

    2006-01-01

    Rotavirus, the most common cause of severe diarrhea and a leading cause of mortality in children, has been a priority target for vaccine development for the past several years. The first rotavirus vaccine licensed in the United States was withdrawn because of an association of the vaccine with intussusception. However, the need for a vaccine is greatest in the developing world, because the benefits of preventing deaths due to rotavirus disease are substantially greater than the risk of intuss...

  1. Radiological features of Meckel's diverticulum and its complications

    International Nuclear Information System (INIS)

    Thurley, P.D.; Halliday, K.E.; Somers, J.M.; Al-Daraji, W.I.; Ilyas, M.; Broderick, N.J.

    2009-01-01

    Meckel's diverticulum is the most common congenital abnormality of the small bowel. The majority of patients with this anomaly will remain asymptomatic; however, several complications may occur, including obstruction, intussusception, perforation, diverticulitis, and gastrointestinal haemorrhage. These complications may produce a variety of different clinical features and radiological appearances. The purpose of this article is to review the potential imaging manifestations of Meckel's diverticulum and its complications and discuss the advantages and disadvantages of the imaging techniques available

  2. Scintigraphic demonstration of inflammatory bowel pathologies in radionuclides Meckel`s diverticular studies

    Energy Technology Data Exchange (ETDEWEB)

    Ciavarelle, F

    1998-12-01

    Radionuclide Meckel`s diverticular studies are commonly requested to help distinguish the source of chronic gastrointestinal blood loss. However, several aetiologies may contribute to false-positive scan findings, for example inflammatory pathologies such as Crohn`s disease, ulcerative colitis, regional enteritis and intussusception, all of which commonly localise pertechnetate. In this paper, two cases of incidental findings on Meckel`s diverticular studies and their impact on patient management will be presented 4 refs., 2 figs.

  3. Scintigraphic demonstration of inflammatory bowel pathologies in radionuclides Meckel's diverticular studies

    International Nuclear Information System (INIS)

    Ciavarelle, F.

    1998-01-01

    Radionuclide Meckel's diverticular studies are commonly requested to help distinguish the source of chronic gastrointestinal blood loss. However, several aetiologies may contribute to false-positive scan findings, for example inflammatory pathologies such as Crohn's disease, ulcerative colitis, regional enteritis and intussusception, all of which commonly localise pertechnetate. In this paper, two cases of incidental findings on Meckel's diverticular studies and their impact on patient management will be presented

  4. Beyond expectations: Post-implementation data shows rotavirus vaccination is likely cost-saving in Australia.

    Science.gov (United States)

    Reyes, J F; Wood, J G; Beutels, P; Macartney, K; McIntyre, P; Menzies, R; Mealing, N; Newall, A T

    2017-01-05

    Universal vaccination against rotavirus was included in the funded Australian National Immunisation Program in July 2007. Predictive cost-effectiveness models assessed the program before introduction. We conducted a retrospective economic evaluation of the Australian rotavirus program using national level post-implementation data on vaccine uptake, before-after measures of program impact and published estimates of excess intussusception cases. These data were used as inputs into a multi-cohort compartmental model which assigned cost and quality of life estimates to relevant health states, adopting a healthcare payer perspective. The primary outcome was discounted cost per quality adjusted life year gained, including or excluding unspecified acute gastroenteritis (AGE) hospitalisations. Relative to the baseline period (1997-2006), over the 6years (2007-2012) after implementation of the rotavirus program, we estimated that ∼77,000 hospitalisations (17,000 coded rotavirus and 60,000 unspecified AGE) and ∼3 deaths were prevented, compared with an estimated excess of 78 cases of intussusception. Approximately 90% of hospitalisations prevented were in children <5years, with evidence of herd protection in older age groups. The program was cost-saving when observed changes (declines) in both hospitalisations coded as rotavirus and as unspecified AGE were attributed to the rotavirus vaccine program. The adverse impact of estimated excess cases of intussusception was far outweighed by the benefits of the program. The inclusion of herd impact and declines in unspecified AGE hospitalisations resulted in the value for money achieved by the Australian rotavirus immunisation program being substantially greater than predicted bypre-implementation models, despite the potential increased cases of intussusception. This Australian experience is likely to be relevant to high-income countries yet to implement rotavirus vaccination programs. Copyright © 2016. Published by Elsevier

  5. Juvenile polyposis syndrome

    OpenAIRE

    Hsiao, Yi-Han; Wei, Chin-Hung; Chang, Szu-Wen; Chang, Lung; Fu, Yu-Wei; Lee, Hung-Chang; Liu, Hsuan-Liang; Yeung, Chun-Yan

    2016-01-01

    Abstract Background: Juvenile polyposis syndrome, a rare disorder in children, is characterized with multiple hamartomatous polyps in alimentary tract. A variety of manifestations include bleeding, intussusception, or polyp prolapse. In this study, we present an 8-month-old male infant of juvenile polyposis syndrome initially presenting with chronic anemia. To the best of our knowledge, this is the youngest case reported in the literature. Methods: We report a rare case of an 8-month-old male...

  6. Intussuscepção intestinal e oclusão intestinal causada por pólipos em intestino delgado na síndrome Peutz-Jeghers. Tratamento com ressecção por enterotomia associado a enteroscopia intra-operatória: relato de caso

    OpenAIRE

    Gama-Rodrigues, Joaquim J.; Silva, José Hyppolito da; Aisaka, Adilson A.; Jureidini, Ricardo; Falci Júnior, Renato; Maluf Filho, Fauze; Chong, A. Kim; Tsai, André Wan Wen; Bresciani, Cláudio

    2000-01-01

    The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyp...

  7. Defecographic findings of young asymptomatic volunteers

    International Nuclear Information System (INIS)

    Yoon, Sang Wook; Park, Hyo Jin; Kim, Ki Whang; Ji, Hoon

    1994-01-01

    Defacography is a technique of examining the rectum and anal canal by using fluoroscopy during detection. This study was done to determine the range of normal findings of defecography in young asymptomatic Korean volunteers. Twenty nine asymptomatic young volunteers underwent defecography. Anorectal angle, perineal descent, length and width of anal, rectocele, rectal intussusception and incontinence were evaluated. The range of anorectal angle was 82 .deg- 149 .deg in resting state, compared to the 63 .deg-116 .deg in squeezing state, and 95 .deg- 116 .deg in straining state respectively. The pelvic floor in straining state descended on average of 1.62 cm from the inferior margin of ischial tuberosity that its broad range of position from-5.2 cm to 0.8 cm implies a wide variation of anorectal angle and perineal descent. Mild degree of rectocele with less than 2 cm of depth was found in 12 out of 29 cases. Rectal intussusception was noted in six and rectal incontinence was seen in one case. Formation of rectocele and intussusception during defecation was common in asymptomatic young volunteers. The wide range of defacographic measurements warrants the necessity of other complementary studies on anorectal function to improve the diagnostic accuracy. The interpretation of defecographic measurement should therefore be made with caution and should not be used as the sole criteria for selection of treatment modality

  8. CT characteristic findings of Meckel's diverticulum and its complications in children

    International Nuclear Information System (INIS)

    Hu Jun; Hu Kefei; Li Gengwu; Yin Chuangao; Zhao Zhen; Wang Yue; Huang He; Gao Qun

    2011-01-01

    Objective: To investigate the CT manifestations of Meckel's diverticulum and its complications in children. Methods: Retrospective analysis of Clinical and CT findings in 25 cases with pathologically proved Meckel's diverticulum. The unenhanced and contrast-enhanced CT were obtained in all patients. Results: (1) The direct signs: the diverticulum cannot be shown in 5 cases; the diverticulums were found around the navel or in lower right abdomen in 20 cases. The blind-ending fluid-filled or gas-filled structures were found in 9 cases, with heterogeneous r/ng-enhancement. The tubercle-like structures were detected in 11 cases, which showed no enhancement in 4 cases, and homogeneous enhancement in 3 cases, and heterogeneous enhancement in 4 cases. (2) The indirect signs included intestine obstruction in 8 cases, swelling fat layer surrounding the diverticulum in 9 cases, free gas around the diverticulum in 3 cases, thickened mesentery in 8 cases, ascites in 4 cases, and intussusception due to inverted Meckel's diverticulum with 'target sign' in 1 case. (3) CT classification: with diverticulitis or diverticular bleeding in 20 cases; with intestine obstruction oi intussusception in 8 cases; bands-caused obstruction in 7 cases, intussusception in 1 case, with perforation in 3 cases. Conclusion: Meckel's diverticulum and its complications have typical CT findings, and CT can clearly demonstrate diverticulum's shape, margin, internal components and surrounding tissues. (authors)

  9. Human Parechovirus as a Cause of Isolated Pediatric Acute Liver Failure.

    Science.gov (United States)

    Bigelow, Amee M; Scott, John P; Hong, Johnny C; Cronin, David C; Vitola, Bernadette E; Fons, Roger A; Petersen, Tara L

    2016-11-01

    Among infants, almost half of acute liver failure cases are classified as indeterminate, whereas only a small number of cases show a documented viral infection. We present the first reported case of isolated acute hepatic failure in an infant in the setting of a human parechovirus (HPeV) infection. HPeV also may have been contributory to the posttransplant complication of 2 intussusceptions. This is a 10-month-old girl who presented with only symptoms of fussiness and was noted to have progressive decline in synthetic liver function as well as worsening coagulopathy requiring a liver transplant. The acute liver failure was in the setting of a positive serum RNA HPeV, subtype 3 (HPeV-3), after extensive diagnostic testing with genetic, autoimmune, and infectious causes otherwise negative. After liver transplantation, the postoperative course was complicated by both an ileal-ileal intussusception as well as a jejunal intussusception. Viral testing in pediatric acute liver failure is often performed, but the workup is frequently incomplete. This case report would support more extensive viral testing in this population of patients. In the setting of HPeV, clinicians could be alerted to the possibility of delayed gastrointestinal pathology in the posttransplant phase. Wider use of routine HPeV testing may more clearly define the variable clinical presentations and outcomes. Copyright © 2016 by the American Academy of Pediatrics.

  10. Desenvolvimento pós-embrionário do intestino anterior de Dermatobia hominis (Linnaeus Jr. (Diptera, Cuterebridae Post-embryonic development of Dermatobia hominis (Linnaeus Jr. (Diptera, Cuterebridae foregut

    Directory of Open Access Journals (Sweden)

    Ana Maria Vieira

    2001-03-01

    Full Text Available Foregut in D. hominis (Linnaeus Jr., 1781 as the majority of the larval Diptera somatic tissue, is made up of polytenic cells, and grows at the expenses of the polytenization of its nuclei followed by the increase in size of each cell. The oesophagus, of ectodermic origem, is interiorly covered by a chitinous squamous epithelium that rests upon a very thin basal lamina. This sheet is surrounded by thick muscle bundles. The oesophagus intussuscepts the midgut forming the cardia. The cardia, with three epithelial layers: two internal ones, of ectodermal origin and one external of endodermic origin. At the anterior portion of the cardia, between these two types of epithelium, there is a cluster of small, non polytenic cells, forming the imaginal disk of the foregut. Metamoiphosis begins at the end of the larval period with signs of nuclear degeneration of all the polytenic cells, as well as the increase in number of the imaginal disk ones. The oesophagic portion intussuscepted into the cardia, everts; its cells suffer apoptosis and are replaced by the new cells growing from the imaginal disk. The external layer cells also degenerate and are pinched off into the lumen of the very anterior portion of the midgut. The newly formed oesophagus intussuscepts "de novo" to form the two internal layers of the adult cardia. At the same time the midgut regenerative cells grow anteriorly to form the new external layer of the adult cardia.

  11. Radiological evaluation of intestinal obstruction in neonate and infant

    International Nuclear Information System (INIS)

    Jeon, D. S.; Lim, K. Y.; Kim, S. J.; Kim, J. D.; Rhee, H. S.

    1980-01-01

    281 cases of neonatal and infantile intestinal obstruction confirmed by clinical and surgical procedure from 1975 till 1979 were reviewed radiologically. The result was as follows; 1. Intussusception was the most common cause of intestinal obstruction under one year of age (173/281: 61.56%), and other causes of descending order were infantile hypertrophic pyloric stenosis (20: 7.11%), congenital megacolon (19: 6.76%), anorectal malformation (17: 6.05%), meconium plug syndrome (17: 6.05%), hernia (12: 4.27%), band adhesion (8: 2.85%), rotation anomaly (5: 1.78%), small bowel atresia (3: 1.07%), Meckel's diverticulum (3: 1.07%), duodenal atresia (2: 0.71%), meconium ileus (1: 0.36%) and annular pancreas (1: 0.36%). Congenital type of intestinal obstruction (we classified intussusception acquired and others congenital) occupied 38.44%. 2. The ratio of male to female was 3: 1, congenital type 4.69 : 1 and acquired 2.39 : 1. 3. Vomiting, bloody stool, fever and abdominal distention were the most 4 symptoms. 4. The frequency of typical mechanical ileus pattern on plain abdomen films was 226 cases(80.43%) paralytic ileus or normal finding was 52 cases (18.51%) and pneumoperitoneum with ileus sign was 3 cases (1.06%). 5. Barium meal or enema was performed in 228 cases and narrowing or obstructed site was found in 213 cases of them (93.42%); intussusception 100% (173/173), infantile hypertrophic pyloric stenosis 93.33% (14/15) and congenital megacolon 82.35% (14/17). 6. Only 10 cases had associated disease such as Mongolism, thoracic kyphosis and scoliosis, microcolon, prematurity, ileocolic fistula, undescended testicle and hydrocele. 7. Meconium plug syndrome, duodenal atresia, small bowel atresia, mecondium ileus and annular pancreas were developed early after birth with average onset age of 3.6 days

  12. The clinical and radiological observation of the intususception in infancy and children

    International Nuclear Information System (INIS)

    Suh, Chee Jang; Kang, Heoung Keun; Chung, Hyon De

    1980-01-01

    Intussusception is the invagination of one portion of the intestine into the contiguous distal segment. During infancy and childhood it is the most common cause of acquired intestinal obstruction. This is a clinical and radiological study of 120 cases who visited our Chonnam National University Hospital from January 1975 to August 1979. The results were summarized as follows; 1. Age, sex and seasonal incidence. In 120 cases, 88.3% of the patients were under the one year of age and peak incidence occurred from 4 to 12 month of age. In sex distribution, male showed definitely higher incidence than in female patients with the ratio of 2.2 : 1. Although the disease occurs the year around, sprig and summer showed somewhat higher incidences. 2. The common symptoms and signs were vomiting (88.3%), bloody stool (81.7%), palpable mass (66.7%), and irritability (29.2%) in order of the frequency. 3. The common x-ray findings of plain abdomen were moderate dilatation of gas filled bowels loop (62.8%), obliteration of the gas shadow in the cecum ascending colon (5.0%), and soft tissue mass density (43%)> 4. The most common obstructing point found by barium enema was at the hepatic flexure. 5. The overall reduction rate by hydrostatic barium reduction was 69.4%, and this rate was increased in the following cases: 1) the duration of symptoms under the 12 hours (89.2%) and between 13 of 24 hour (70%). 2) no evidence of severe small bowel obstruction. 3) in the cases of ileocecal, ileocolic or colocolic of the type of intussusception. 6. Recurrence rate was 4.2%. 7. Mortality rate in 120 cases of intussusception was 2.5%.

  13. La créativité gestuelle et linguistique des élèves débutant l’apprentissage de l’anglais à l’école primaire

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    Marie Potapushkina-Delfosse

    2016-05-01

    Full Text Available Cet article étudie les phénomènes de créativité gestuelle et linguistique manifestés par les élèves de l'école primaire qui débutent leur apprentissage de l'anglais dans le cadre d'une approche multimodale reliant le geste, le théâtre, le conte, et basée sur la théorie de l'intussusception de Marcel Jousse, appartenant au champ de l’anthropologie linguistique. Le processus d’intussusception s’opère selon la logique suivante : - l’homme est agi par la réalité ; - les actions qu’il reçoit et rejoue (imprime et exprime deviennent gestes ; - le geste est d'abord global (impliquant l'homme dans toute sa corporéité, puis, par économie expressive, il devient manuel (notre gesticulation communicative et enfin laryngo-buccal (parole. La production des signaux kinésiques et linguistiques apparaît donc comme relevant du même phénomène dont la nature est intrinsèquement créative grâce au mécanisme de rejeu. Dans les années 1960-1990, Jacques Lecoq a élaboré une méthodologie de formation théâtrale intégrant la logique joussienne d’intussusception. L’approche d’enseignement de l’anglais présentée dans cet article s’inspire du théâtre du geste de Lecoq tout en accordant une place importante au conte qui est une représentation symbolique du monde, correspondant le mieux à la perception enfantine, selon Bruno Bettelheim et Kieran Egan.

  14. A novel germline mutation (c.A527G) in STK11 gene causes Peutz-Jeghers syndrome in a Chinese girl: A case report.

    Science.gov (United States)

    Zhao, Zi-Ye; Jiang, Yu-Liang; Li, Bai-Rong; Yang, Fu; Li, Jing; Jin, Xiao-Wei; Sun, Shu-Han; Ning, Shou-Bin

    2017-12-01

    Peutz-Jeghers syndrome (PJS) is a Mendelian autosomal dominant disease caused by mutations in the tumor suppressor gene, serine/threonine kinase 11 (STK11). The features of this syndrome include gastrointestinal (GI) hamartomas, melanin spots on the lips and the extremities, and an increased risk of developing cancer. Early onset of disease is often characterized by mucocutaneous pigmentation and intussusception due to GI polyps in childhood. A girl with a positive family history grew oral pigmentation at 1 and got intussusception by small bowel hamartomas at 5. She was diagnosed with PJS based on oral pigmentation and a positive family history of PJS. Enteroscopy was employed to treat the GI polyps. Sanger sequencing was used to investigate STK11 mutation in this family. A large jejunal polyp together with other smaller ones was resected, and the girl recovered uneventfully. We discovered a heterozygous substitution in STK11, c.A527G in exon 4, in the girl and her father who was also a PJS patient, and the amine acid change was an aspartic acid-glycine substitution in codon 176. This mutation was not found in other healthy family members and 50 unrelated non-PJS controls, and it is not recorded in databases, which prove it a novel mutation. Evolutionary conservation analysis of amino acid residues showed this aspartic acid is a conserved one between species, and protein structure prediction by SWISS-MODEL indicated an obvious change in local structure. In addition, PolyPhen-2 score for this mutation is 1, which indicates it probably damaging. PJS can cause severe complication like intussusception in young children, and early screening for small bowel may be beneficial for these patients. The mutation of STK11 found in this girl is a novel one, which enlarges the spectrum of STK11. Our analysis supported it a causative one in PJS.

  15. Usefulness of colon transit time and defecography in patients with chronic constipation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyoung Seuk; Chung, Jae Joon; Kim, Myung Hyun; Park, Su Mi; Yang, Hee Chul [NHIC Ilsan Hospital, Ilsan (Korea, Republic of)

    2006-05-15

    We wanted to evaluate whether both the colonic transit time (CTT) and defecography are necessary for diagnosing constipated patients, and we also wanted to assess the defecographic findings of patients with outlet obstruction on CTT. Over the recent 3 years, 26 patients (21 women and 5 men, mean age: 59 years) underwent both CTT and defecography because of their chronic constipations or defecation difficulty. The mean interval between the 2 studies was 48 days. Colonoscopy, barium enema and manometry were performed in 22, 8 and all the patients, respectively. On CTT, 13 patients (50.0%) were normal and 13 patients (50.0%) were abnormal; the abnormal results were composed of outlet obstruction (n = 8, 30.8%), outlet obstruction and colon inertia (n = 2, 7.7%), colon inertia (n = 2, 7.7%), and outlet obstruction and hindgut dysfunction (n = 1, 3.8%). On defecography, 6 patients (23.1%) were normal and 20 patients (76.9%) were abnormal; the results were composed of rectocele (n = 8, 30.7%), rectocele and perineal descent syndrome (PDS; n = 4, 15.4%), PDS and rectal intussusception (n = 3, 11.5%), spastic pelvic floor syndrome (SPFS; n = 3, 11.5%), rectocele and SPFS (n = 1, 3.8%), and rectal intussusception (n = 1, 3.8%). Of the 11 patients with outlet obstruction on CTT, rectocele (n = 4, 36.4%), SPFS (n = 1, 9.1%), rectocele and PDS (n = 1, 9.1%), and PDS and rectal intussusception (n = 1, 9.1%) were demonstrated on defecography, except for the 4 normal cases. Both CTT and defecography were necessary for diagnosing the patients with chronic constipation in compensation, and 63.6% of the patients with pelvic outlet obstruction showed an abnormal pelvic defecation function.

  16. Usefulness of colon transit time and defecography in patients with chronic constipation

    International Nuclear Information System (INIS)

    Park, Kyoung Seuk; Chung, Jae Joon; Kim, Myung Hyun; Park, Su Mi; Yang, Hee Chul

    2006-01-01

    We wanted to evaluate whether both the colonic transit time (CTT) and defecography are necessary for diagnosing constipated patients, and we also wanted to assess the defecographic findings of patients with outlet obstruction on CTT. Over the recent 3 years, 26 patients (21 women and 5 men, mean age: 59 years) underwent both CTT and defecography because of their chronic constipations or defecation difficulty. The mean interval between the 2 studies was 48 days. Colonoscopy, barium enema and manometry were performed in 22, 8 and all the patients, respectively. On CTT, 13 patients (50.0%) were normal and 13 patients (50.0%) were abnormal; the abnormal results were composed of outlet obstruction (n = 8, 30.8%), outlet obstruction and colon inertia (n = 2, 7.7%), colon inertia (n = 2, 7.7%), and outlet obstruction and hindgut dysfunction (n = 1, 3.8%). On defecography, 6 patients (23.1%) were normal and 20 patients (76.9%) were abnormal; the results were composed of rectocele (n = 8, 30.7%), rectocele and perineal descent syndrome (PDS; n = 4, 15.4%), PDS and rectal intussusception (n = 3, 11.5%), spastic pelvic floor syndrome (SPFS; n = 3, 11.5%), rectocele and SPFS (n = 1, 3.8%), and rectal intussusception (n = 1, 3.8%). Of the 11 patients with outlet obstruction on CTT, rectocele (n = 4, 36.4%), SPFS (n = 1, 9.1%), rectocele and PDS (n = 1, 9.1%), and PDS and rectal intussusception (n = 1, 9.1%) were demonstrated on defecography, except for the 4 normal cases. Both CTT and defecography were necessary for diagnosing the patients with chronic constipation in compensation, and 63.6% of the patients with pelvic outlet obstruction showed an abnormal pelvic defecation function

  17. Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

    Directory of Open Access Journals (Sweden)

    Sthela Maria Murad-Regadas

    2012-06-01

    Full Text Available CONTEXT: Management of patients with obstructed defecation syndrome is still controversial. OBJECTIVE: To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. METHODS: The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33% patients with significant improvement of symptoms through clinical management only. Group II: 14 (14% with improvement through clinical treatment plus biofeedback. Group III: 55 (53% referred to surgery due to treatment failure. RESULTS: Group I: 20 (59% patients had grade-II rectocele, 14 (41% grade-III. Obstructed defecation syndrome was associated with intussusception (41%, mucosal prolapse (41%, anismus (29%, enterocele (9% or 2 dysfunctions (23%. The average constipation score decreased significantly from 11 to 5. Group II: 11 (79% grade-II rectocele, 3 (21% grade-III, associated with intussusception (7%, mucosal prolapse (43%, anismus (71% or 2 dysfunctions (29%. There was significant decrease in constipation score from 13 to 6. Group III: 8 (15% grade-II rectocele, 47 (85% grade-III, associated with intussusception (42%, mucosal prolapse (40% or 2 dysfunctions (32%. The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31% patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. CONCLUSIONS: Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in

  18. Radiological evaluation of intestinal obstruction in neonate and infant

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, D. S.; Lim, K. Y.; Kim, S. J.; Kim, J. D.; Rhee, H. S. [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1980-12-15

    281 cases of neonatal and infantile intestinal obstruction confirmed by clinical and surgical procedure from 1975 till 1979 were reviewed radiologically. The result was as follows; 1. Intussusception was the most common cause of intestinal obstruction under one year of age (173/281: 61.56%), and other causes of descending order were infantile hypertrophic pyloric stenosis (20: 7.11%), congenital megacolon (19: 6.76%), anorectal malformation (17: 6.05%), meconium plug syndrome (17: 6.05%), hernia (12: 4.27%), band adhesion (8: 2.85%), rotation anomaly (5: 1.78%), small bowel atresia (3: 1.07%), Meckel's diverticulum (3: 1.07%), duodenal atresia (2: 0.71%), meconium ileus (1: 0.36%) and annular pancreas (1: 0.36%). Congenital type of intestinal obstruction (we classified intussusception acquired and others congenital) occupied 38.44%. 2. The ratio of male to female was 3: 1, congenital type 4.69 : 1 and acquired 2.39 : 1. 3. Vomiting, bloody stool, fever and abdominal distention were the most 4 symptoms. 4. The frequency of typical mechanical ileus pattern on plain abdomen films was 226 cases(80.43%) paralytic ileus or normal finding was 52 cases (18.51%) and pneumoperitoneum with ileus sign was 3 cases (1.06%). 5. Barium meal or enema was performed in 228 cases and narrowing or obstructed site was found in 213 cases of them (93.42%); intussusception 100% (173/173), infantile hypertrophic pyloric stenosis 93.33% (14/15) and congenital megacolon 82.35% (14/17). 6. Only 10 cases had associated disease such as Mongolism, thoracic kyphosis and scoliosis, microcolon, prematurity, ileocolic fistula, undescended testicle and hydrocele. 7. Meconium plug syndrome, duodenal atresia, small bowel atresia, mecondium ileus and annular pancreas were developed early after birth with average onset age of 3.6 days.

  19. A case of asymptomatic ileal duplication cyst associated with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Hülya İpek

    2017-07-01

    Full Text Available Duplications of the alimentary tract are infrequent anomalies. They are most frequently located in the terminal ileum, and majority of them became symptomatic before the age of 2. Presenting symptoms may include abdominal mass, intestinal obstruction, intussusception, rectal bleeding, and abdominal pain. Preoperative diagnosis is usually difficult, intra-abdominal duplications are usually diagnosed during surgical explorations of above complications. We presented a 12-year-old girl with asymptomatic ileal duplication cyst associated with non-complicated acute appendicitis, whose imaging studies at admission were compatible with complicated perforated appendicitis.

  20. Enterobius Vermicularis as a Cause of Intestinal Occlusion: How To Avoid Unnecessary Surgery.

    Science.gov (United States)

    Adorisio, Ottavio; De Peppo, Francesco; Rivosecchi, Massimo; Silveri, Massimiliano

    2016-04-01

    Enterobius vermicularis may cause infections of the gastrointestinal tract and occurs approximately in 4% to 28% of children worldwide. It is most common in children aged 5 to 14 years.The most commonly reported symptoms are pruritus in the perianal region, abdominal pain, urinary tract infection, insomnia, irritability, salpingitis, and appendicitis, whereas intestinal obstruction is a very rare but would be considered to perform the right instrumental examination avoiding unnecessary surgical exploration.We report a case of an 8-year-old boy with an intestinal occlusion due to a colonic intussusception by Enterobius vermicularis managed conservatively.

  1. Torsion and volvulus of the transverse and descending colon in a German shepherd dog.

    Science.gov (United States)

    Halfacree, Z J; Beck, A L; Lee, K C L; Lipscomb, V J

    2006-08-01

    A German shepherd dog was presented two months after surgery for correction of acute gastric dilatation volvulus. The dog had been diagnosed with exocrine pancreatic insufficiency. Radiographs revealed marked gaseous distension of one loop of intestine with a generalised increase in intestinal gas content. A 360 degrees anticlockwise rotation of the descending and transverse colon, around the longitudinal axis of the mesocolon, was diagnosed at exploratory coeliotomy. The transverse and descending colon appeared uniformly necrotic and an end-to-end colo-colic resection and anastomosis was performed. The dog initially made satisfactory postoperative progress but was euthanased on the third postoperative day after it developed an intestinal intussusception.

  2. A rare complication of Meckel's diverticulum: A fistula between Meckel's diverticulum and the appendix

    Directory of Open Access Journals (Sweden)

    Ping-Fu Yang

    2012-10-01

    Full Text Available Meckel diverticulum is the most common congenital anomaly of the small intestine, occurring in about 2%–4% of the population. Meckel diverticulum results from incomplete closure of the omphalomesenteric duct. The presentation of symptomatic Meckel diverticulum includes gastrointestinal hemorrhage, intestinal obstruction, volvulus, intussusception, diverticulitis, and neoplasms. The development of fistula is an extremely rare complication. Previous literature has even shown an enterocolonic fistula, a vesicodiverticular fistula, ileorectal fistula, and fistula-in-ano. To the best of our knowledge, we present the first case of the fistula complicated between Meckel diverticulum and the appendix in a review of the English literature.

  3. Jejunal Diverticula Causing Unusual Massive Lower Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Chiong-Hee Wong

    2008-09-01

    Full Text Available Jejunal diverticula are rare and difficult to diagnose. They are often asymptomatic, but they may infrequently cause serious acute complications, such as diverticulitis with or without perforation, volvulus, intussusception, or hemorrhage. Hemorrhage of jejunal diverticula usually presents as lower gastrointestinal bleeding. Diverticula with bleeding may be associated with some anticoagulants, antiplatelets or nonsteroidal antiinflammatory agents in the elderly. In our case, upper gastroscopy and colonoscopy could not easily disclose the bleeding. Selective mesenteric angiography is the gold standard for diagnosis of active and fatal bleeding. The management of a bleeding jejunal diverticulum is surgical resection of the involved segment of jejunum.

  4. Perforated Meckel’s diverticulum in an adult due to faecolith: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Sunny Modi

    2015-01-01

    Full Text Available Meckel’s diverticulum (MD is a persistent remnant of the vitelointestinal duct and is present in 2% of population [1]. It is the most common congenital malformation of the gastrointestinal tract. It can present clinically as haemorrhage, diverticulitis, intussusception, chronic ulceration, intestinal obstruction and perforation. Complicated presentation, especially bleeding, tends to be more common in the paediatric group, whereas intestinal obstruction is more common in adults [2]. Patients with a perforation of Meckel’s diverticulum by an enterolith are rare and may present with right iliac fossa pain, which mimics acute appendicitis.

  5. CT Findings of Colonic Complications Associated with Colon Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young; Kim, Young Tong; Kim, Chang Jin [Cheonan Hospital, Soonchunhyang University, Cheonan (Korea, Republic of)

    2010-04-15

    A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.

  6. Imaging Findings of the Unusual Presentations, Associations and Clinical Mimics of Acute Appendicitis.

    Science.gov (United States)

    Demir, Mustafa Kemal; Savas, Yildiray; Furuncuoglu, Yavuz; Cevher, Tarik; Demiral, Serdar; Tabandeh, Babek; Aslan, Melisa

    2017-10-01

    There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.

  7. Imaging findings of acute abdomen with intraperitoneal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Ji Seon; Kim, Mi Young; Koo, Jin Hoi; Cho, Soon Gu; Suh, Chang Hae [Inha Univ. College of Medicine, Inchon (Korea, Republic of)

    2000-12-01

    Acute abdomen caused by abdominal tuberculosis is a rare manifestation, and includes bleeding of a gastric or ileal ulcer, obstruction of the small bowel by an adhesive band, perforation of the ileum, ileocolic intussusception and fistula, and mesenteric abscesses caused by necrotic lymph nodes. The clinical and radiologic features of these complicated tuberculosis may mimic other acute abdominal diseases. Although not definitive, careful evaluation of the radiologic findings of the bowel wall, mesenteric fat infiltration, and lymph node enlargement may provide useful diagnostic clues to the presence of acute abdomen due to tuberculosis.

  8. MR defecography for obstructed defecation syndrome

    Directory of Open Access Journals (Sweden)

    Ravikumar B Thapar

    2015-01-01

    Full Text Available Patients with obstructed defecation syndrome (ODS form an important subset of patients with chronic constipation. Evaluation and treatment of these patients has traditionally been difficult. Magnetic resonance defecography (MRD is a very useful tool for the evaluation of these patients. We evaluated the scans and records of 192 consecutive patients who underwent MRD at our center between January 2011 and January 2012. Abnormal descent, rectoceles, rectorectal intussusceptions, enteroceles, and spastic perineum were observed in a large number of these patients, usually in various combinations. We discuss the technique, its advantages and limitations, and the normal findings and various pathologies.

  9. Cellulose synthesis inhibition, cell expansion, and patterns of cell wall deposition in Nitella internodes

    International Nuclear Information System (INIS)

    Richmond, P.A.; Metraux, J.P.

    1984-01-01

    The authors have investigated the pattern of wall deposition and maturation and correlated it with cell expansion and cellulose biosynthesis. The herbicide 2,6-dichlorobenzonitrile (DCB) was found to be a potent inhibitor of cellulose synthesis, but not of cell expansion in Nitella internodal cells. Although cellulose synthesis is inhibited during DCB treatment, matrix substances continue to be synthesized and deposited. The inhibition of cellulose microfibril deposition can be demonstrated by various techniques. These results demonstrate that matrix deposition is by apposition, not by intussusception, and that the previously deposited wall moves progressively outward while stretching and thinning as a result of cell expansion

  10. Large Neurofibroma of the Anorectal Canal: A Case Report

    Directory of Open Access Journals (Sweden)

    Seyed Vahid Hosseini

    2011-01-01

    Full Text Available Neurofibromatosis type 1, also known as von Recklinghausen disease, is an autosomal dominant disorder with an incidence of 1 per 4000. Neurofibromas are benign, heterogeneous tumors arising from the connective tissue of peripheral nerve sheaths, especially the endoneurium. Visceral involvement in disseminated neurofibromatosisis rare. Neurofibroma occurs most frequently in the stomach and jejunum, but the colon and anorectal canal may also be involved. Gastrointestinal neurofibromas may lead to bleeding, obstruction, intussusception, protein-losing enteropathy and bowel perforation.We present a case of diffuse involvement of the anorectal area by a huge neurofibroma, with pelvic pain, watery diarrhea and urgency.

  11. CT Findings of Colonic Complications Associated with Colon Cancer

    International Nuclear Information System (INIS)

    Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young; Kim, Young Tong; Kim, Chang Jin

    2010-01-01

    A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer

  12. Polyposis syndromes: pediatric implications.

    Science.gov (United States)

    Hyer, W

    2001-10-01

    The diagnosis of a polyposis syndrome, such as juvenile polyposis, Peutz-Jeghers syndrome, and familial adenomatous polyposis, requires knowledge of the site, number, and histologic type of the polyps and an appreciation of relevant family history. Children and adolescents with polyposis syndromes are faced with not only the immediate complications of the polyps, such as intussusception or bleeding, but also the extraintestinal manifestations and the long-term risk for malignancy. This article reviews the diagnosis, clinical management, surveillance, and surgical options for children with polyposis syndromes and discusses genetics and appropriate screening programs.

  13. Sonographic diagnosis of juvenile polyps in children.

    Science.gov (United States)

    Zhang, Yao; Li, Shi-Xing; Xie, Li-Mei; Shi, Bo; Ju, Hao; Bai, Yu-Zuo; Zhang, Shu-Cheng

    2012-09-01

    The aim of this study was to assess the diagnostic value of ultrasonography for juvenile polyps in children and their sonographic characteristics. A retrospective analysis was performed of the ultrasound findings in 27 children who were diagnosed preoperatively with juvenile polyp within the intestinal tract by ultrasonography and then confirmed by colonoscopy, laparotomy and histopathology. The ultrasonic finding common to all polyps was an isolated intraluminal nodular or massive protrusion, associated with multiple mesh-like fluid areas of different sizes. In 25 children, surrounding pedicle-like low echoes of varying lengths were seen connecting with the polyps to form "mushroom" sign. The color Doppler showed abundant blood flow signals within all polyps and pedicles in a shape of a branch or an umbrella. For seven children with an intussusception, the polyp shadow was detected in the cervical part or interior of the intussusception. Ultrasonography is, thus, considered to be a feasible method for diagnosing intestinal juvenile polyp. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  14. Peutz-Jegher syndrome in childhood: need for updated recommendations?

    Science.gov (United States)

    Goldstein, Stephanie A; Hoffenberg, Edward J

    2013-02-01

    We reviewed our institution's experience with Peutz-Jegher syndrome (PJS) in children to determine whether current recommendations on timing of screening and follow-up should be modified. We reviewed the charts of all of the children with a diagnosis of PJS at our institution from 2000 to 2011 abstracting data on intussusceptions events, polyp characteristics, Sertoli cell (SC) tumors, family history, imaging, and interventions. Of 14 children identified, 10 were boys. Median age at first clinical evaluation was 4.5 years, and family history and/or mucocutaneous pigmentation were the 2 most common factors stimulating screening. Median age at first screening test was 5 years (range 1-16), and at first polyp identification, 5 years (range 1 to 18). There were 7 intussusception events in 5 children, with median age of 10 and range 5 to 16 for first event. Two boys had SC tumors at 8 and 11 years. Polyps were identified during initial screening in 9 of 14 patients. Polyps were found in the stomach or duodenum in 5 (36%), small bowel in 7, (50%) and colon in 3 (21%) children. Large polyps were identified in 9 children at median age of 7 years. Polyps causing significant clinical consequences can occur frequently in children with PJS younger than 8 years. Revised guidelines should consider initial screening at age 4 to 5 with capsule endoscopy and upper and lower endoscopy as well as evaluation for SC tumors and re-evaluation whenever symptoms suggest polyp-associated complications.

  15. Stretch-induced intussuceptive and sprouting angiogenesis in the chick chorioallantoic membrane.

    Science.gov (United States)

    Belle, Janeil; Ysasi, Alexandra; Bennett, Robert D; Filipovic, Nenad; Nejad, Mohammad Imani; Trumper, David L; Ackermann, Maximilian; Wagner, Willi; Tsuda, Akira; Konerding, Moritz A; Mentzer, Steven J

    2014-09-01

    Vascular systems grow and remodel in response to not only metabolic needs, but also mechanical influences as well. Here, we investigated the influence of tissue-level mechanical forces on the patterning and structure of the chick chorioallantoic membrane (CAM) microcirculation. A dipole stretch field was applied to the CAM using custom computer-controlled servomotors. The topography of the stretch field was mapped using finite element models. After 3days of stretch, Sholl analysis of the CAM demonstrated a 7-fold increase in conducting vessel intersections within the stretch field (p0.05). In contrast, corrosion casting and SEM of the stretch field capillary meshwork demonstrated intense sprouting and intussusceptive angiogenesis. Both planar surface area (p<0.05) and pillar density (p<0.01) were significantly increased relative to control regions of the CAM. We conclude that a uniaxial stretch field stimulates the axial growth and realignment of conducting vessels as well as intussusceptive and sprouting angiogenesis within the gas exchange capillaries of the ex ovo CAM. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Stretch-induced Intussuceptive and Sprouting Angiogenesis in the Chick Chorioallantoic Membrane

    Science.gov (United States)

    Belle, Janeil; Ysasi, Alexandra; Bennett, Robert; Filipovic, Nenad; Nejad, Mohammad Imani; Trumper, David L.; Ackermann, Max; Wagner, Willi; Tsuda, Akira; Konerding, Moritz A.; Mentzer, Steven J.

    2014-01-01

    Vascular systems grow and remodel in response to not only metabolic needs, but mechanical influences as well. Here, we investigated the influence of tissue-level mechanical forces on the patterning and structure of the chick chorioallantoic membrane (CAM) microcirculation. A dipole stretch field was applied to the CAM using custom computer-controlled servomotors. The topography of the stretch field was mapped using finite element models. After 3 days of stretch, Sholl analysis of the CAM demonstrated a 7-fold increase in conducting vessel intersections within the stretch field (p0.05). In contrast, corrosion casting and SEM of the stretch field capillary meshwork demonstrated intense sprouting and intussusceptive angiogenesis. Both planar surface area (p<0.05) and pillar density (p<0.01) were significantly increased relative to control regions of the CAM. We conclude that a uniaxial stretch field stimulates the axial growth and realignment of conducting vessels as well as intussusceptive and sprouting angiogenesis within the gas exchange capillaries of the ex ovo CAM. PMID:24984292

  17. In patients with rectoceles and obstructed defecation syndrome, surgery should be the option of last resort.

    Science.gov (United States)

    Hicks, Caitlin W; Weinstein, Milena; Wakamatsu, May; Savitt, Lieba; Pulliam, Samantha; Bordeianou, Liliana

    2014-04-01

    The indications for operation in patients with obstructed defecation syndrome (ODS) with rectocele are not well defined. A total of 90 female patients with ODS and rectocele were prospectively evaluated and treated with fiber supplements and biofeedback training. Univariate and multivariate regression was used to determine factors predictive of failing medical management. Obstructive symptoms were the most prevalent presenting complaint (82.2%). Ultimately, 71.1% of patients responded to medical management and biofeedback. Multivariate regression analysis suggested that the presence of internal intussusception was associated with a lower chance of undergoing surgery to address ODS symptoms [odds ratio 0.18; P = .05], whereas inability to expel balloon, contrast retention on defecography, and splinting were not (P ≥ .15). Rectoceles with concomitant intussusception in patients with ODS appear to portend a favorable response to biofeedback and medical management. We argue that all patients considered for surgery for rectoceles because of ODS should first undergo appropriate bowel retraining. Copyright © 2014 Mosby, Inc. All rights reserved.

  18. A designated centre for people with disabilities operated by MooreHaven Centre (Tipperary) Ltd, Tipperary

    LENUS (Irish Health Repository)

    Abbasakoor, Noormuhammad O

    2010-01-01

    ABSTRACT: INTRODUCTION: The occurrence of intussusception in adults is rare. The condition is found in 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. The child to adult ratio is 20:1. CASE PRESENTATION: A 52-year-old Irish Caucasian woman was investigated for a 3-month history of intermittent episodes of colicky midgut pain and associated constipation. Ileocolonoscopy revealed a pedunculated lesion in the terminal ileum prolapsing into the caecum. Computed tomography confirmed a smooth-walled, nonobstructing, low density intramural lesion in the terminal ileum with secondary intussusception. A laparoscopic small bowel resection was performed. Histology revealed a large pedunculated polypoidal mass measuring 4 x 2.5 x 2 cm consistent with a submucosal lipoma. She had complete resolution of her symptoms and remained well at 12-month follow-up. CONCLUSION: This case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation. Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning.

  19. Partial spontaneous anal expulsion of the right colon lipoma: An exceptional diagnostic circumstance

    Directory of Open Access Journals (Sweden)

    Fahmi Hamila

    Full Text Available Introduction: Lipomas are most common benign tumors of the colon. They are asymptomatic and fortuitously discovered on a morphological examination. Rarely, they cause complications such as acute intussusception. In this article, we reported an exceptional discovery mode of right colon lipoma. Case presentation: A 54-year-old woman has consulted for acute abdominal pain relieved by the anus emission of a fat ball that she brought back with her. Abdominal computed tomography scan showed the remaining part of a lipoma developed in her right colon. Laparoscopic right colonic resection was performed. Discussion: Colic lipomas are usually asymptomatic and surgical indication in these cases is debated, but it is indicated whenever complications occur such as acute intestinal intussusception. In this case, discovery mode was not considered as a complication because lipoma evacuation could have been complete. Radiological explorations and colonoscopy could evaluate the lesional state. When surgery is decided, intersecting therapeutic strategy of a short colonic resection guided by a colonization during colonoscopy should be considered. Conclusion: The spontaneous expulsion of a colonic lipoma is very rare. Our observation showed that this expulsion may be partial. +The changes that the lipoma undergoes can evoke a malignant cause. a supplement to take care of this eventuality is necessary. Keywords: Colonic lipoma, Spontaneous expulsion, Colectomy

  20. Surgical complications of Ascaris lumbricoides in children

    Directory of Open Access Journals (Sweden)

    Raghu S Ramareddy

    2012-01-01

    Full Text Available Aim : To report the surgical complications of Ascaris lumbricoides infestation in children. Materials and Methods : This is a retrospective study and cases of intestinal ascariasis managed conservatively were excluded. Results : Sixteen children presented with Ascariasis sequelae, which included ileal volvulus (n=5, perforations (n=4, intussusception (n=1, biliary ascariasis (n-1 and impacted multiple worm boluses (n=5. Plain abdominal radiographs showed pneumoperitoneum (3, cigar bundle appearance (3 and multiple air and fluid levels (13. Sonography showed floating worms with free fluid (2, sluggish peristalsis and moderate free fluid (7 and intestinal worm bolus (11. The surgical procedures included milking of worms (in all, bowel resection (6, closure of perforation (3 and manual reduction of intussusception (1. Biliary ascariasis was managed conservatively and the progress monitored with sonography. There were 3 deaths all of whom had intestinal volvulus, bowel necrosis and toxemia. Conclusion : Sonography can be helpful in diagnosing the presence of worms, its complications and in evaluating response to treatment. Early surgical intervention in those with worm bolus, peritonism, and volvulus may salvage bowel and reduce mortality.

  1. An unusual presentation of a malignant jejunal tumor and a different management strategy

    Directory of Open Access Journals (Sweden)

    Parida Dillip K

    2005-01-01

    Full Text Available Abstract Background Malignant small bowel tumors are very rare and leiomyosarcoma accounts for less than 15% of the cases. Management of these tumors is challenging in view of nonspecific symptoms, unusual presentation and high incidence of metastasis. In this case report, an unusual presentation of jejunal sarcoma and management of liver metastasis with radiofrequency ablation (RFA is discussed. Case presentation A 45-year-old male presented with anemia and features of small bowel obstruction. Operative findings revealed a mass lesion in jejunum with intussusception of proximal loop. Resection of bowel mass was performed. Histopathological findings were suggestive of leiomyosarcoma. After 3-years of follow-up, the patient developed recurrence in infracolic omentum and a liver metastasis. The omental mass was resected and liver lesion was managed with radiofrequency ablation. Conclusion Jejunal leiomyosarcoma is a rare variety of malignant small bowel tumor and a clinical presentation with intussusception is unusual. We suggest that an aggressive management approach using a combination of surgery and a newer technique like RFA can be attempted in patients with limited metastatic spread to liver to prolong the long-term survival in a subset of patients.

  2. Intestinal obstruction after Roux-en-Y gastric bypass by Higa's technique for treatment of morbid obesity: radiological aspects

    Energy Technology Data Exchange (ETDEWEB)

    Labrunie, Ester Moraes [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: emlabrunie@superig.com.br; Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia

    2007-05-15

    Objective: The aim of this study is to describe the main radiological aspects of postoperative intestinal obstruction in patients submitted to Roux-en-Y gastric bypass by means of the Higa's technique. Materials and methods: A total of 10 patients presenting with postoperative intestinal obstruction following a gastric reduction procedure were evaluated in the period between November 2001 and April 2006, in seven different medical centers. Results: In the ten patients, the obstruction occurred in the small bowel, five of them because of internal hernias, three because of adhesions, one because of an umbilical hernia and one because of intussusception. Four patients presented obstruction early in the postoperative period (by the seventh post-op day), and six, late in the postoperative period (between the third month and the fifth year). Conclusion: All of the cases of intestinal obstruction were found in the small bowel. Internal hernia was the most frequent cause, followed by adhesion. Other causes included umbilical hernia and intussusception. (author)

  3. Gastrointestinal polyps in children.

    Science.gov (United States)

    Wang, Li-Chun; Lee, Hung-Chang; Yeung, Chun-Yan; Chan, Wai-Tao; Jiang, Chuen-Bin

    2009-10-01

    Gastrointestinal polyps are common in children. The purpose of this study was to review the clinical manifestations, diagnostic procedures, endoscopic findings, management, pathology, and recurrence of gastrointestinal polyps in children at Mackay Memorial Hospital. We retrospectively reviewed the charts of 50 children with a diagnosis of gastrointestinal polyps managed at Mackay Memorial Hospital between January 1984 and April 2007. Demographic data; clinical features; polyp size, number and location; endoscopic findings; management; pathology; and information on recurrences were extracted from the clinical records. The distribution of polyps in the 50 patients included gastric (4 patients), duodenal (2), ileocecal (4) and colorectal polyps (40). All patients with gastric polyps presented with vomiting, and three of the four patients with ileocecal polyps presented with intussusception. The mean age of the 40 patients with colorectal polyps was 6.8 years. The majority of those polyps were in the rectosigmoid colon; 36 patients presented with hematochezia. Solitary polyps were identified in 33 patients and multiple polyps were identified in seven patients. Most of the colorectal polyps were less than 2cm in diameter. Histologically, the most frequent type was juvenile polyp. Gastrointestinal polyps in children are usually benign. Pediatricians treating a child with a gastrointestinal polyp should pay attention to the immediate complications of the polyps, such as intussusception or bleeding, the extraintestinal manifestations and long-term risk for malignancy.

  4. CT findings of small bowel metastases from primary lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Wook; Ha, Hyun Kwon; Kim, Ah Young; Kim, Gab Choul; Kim, Tae Kyoung; Kim, Pyo Nyun; Lee, Moon Gyu [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2002-11-01

    To evaluate the CT findings of small bowel metastases from primary lung cancer. Of the 1468 patients with primary lung cancer between 1990 and 2000, 13 patients who had metastasis to the small intestine were collected. Of these 13 patients, nine who underwent CT scan were included for analysis. The pathologic diagnoses of primary lung cancer in these nine patients were squamous cell carcinoma in six, adenocarcinoma in two, and large cell carcinoma in one. CT scans were analyzed with regard to the site and patterns (intraluminal mass/bowel wall thickening/bowel implants) of metastatic masses, and the presence or absence of complication such as intussusception, obstruction, or perforation of the small bowel. The medical records of the patients were also reviewed retrospectively for evaluation of presenting abdominal symptom and time interval of metastases from initial diagnosis of lung cancer. Metastatic lesions were distributed throughout the small intestine: the duodenum in five, the jejunum in four, the ileum in six, and both jejunum and ileum in one patient. The size of metastatic masses of small bowel ranged from 1.3 cm to 5.0 cm (mean size, 2.6 cm) On CT, the small bowel was involved with intraluminal masses (mean size, 3.4 cm) in eight patients, diffuse wall thickening (mean thickness, 1.6 cm) in five, and bowel implants (mean size, 2.2 cm) in two. Complications occurred in seven patients, including intussusceptions without obstruction in two patients and with obstruction in two, obstruction without intussusceptions in two, and bowel perforation in one. Of 9 patients, 6 had at least one symptom referable to the small bowel including abdominal pain in 4, anemia in 3, vomiting in 1, and jaundice in 1. Lung cancer and small bowel lesions were detected simultaneously in four patients and the time interval of metastases from initial diagnosis of lung cancer ranged from 10 days to 30 months (median interval, 54 days) in patients. CT helps in defining the extent and

  5. WHO informal consultation on quality, safety and efficacy specifications for live attenuated rotavirus vaccines Mexico City, Mexico, 8-9 February 2005.

    Science.gov (United States)

    Wood, David

    2005-12-01

    Rotavirus vaccines are at an advanced stage of development but there are as yet no WHO recommendations on production and quality control to provide regulatory guidance. A meeting of experts was convened by WHO and PAHO/AMRO to review the scientific basis for production and quality control of rotavirus vaccines, and to discuss specific measures to assure the safety and efficacy of rotavirus vaccines. The meeting was attended by 25 experts from 14 countries, drawn from academia, public health, national regulatory authorities and vaccine producers. It was agreed that existing guidance for other live virus vaccines provides a very good basis for product characterization, especially for source materials and control of production. The basis for attenuation of current vaccines or vaccine candidates is not known but, at least for the vaccines based on the Jennerian approach of using animal (bovine) rotaviruses, is likely to be multigenic. The risk of intussusception in humans is influenced by genetic background and age. Recent analyzes of large vaccine safety trials found that certain strains of vaccine virus were not associated with intussusception, although in these trials the first dose of vaccine was not administered to children over 3 months of age. Since age is a risk factor for intussusception, this may suggest that early delivery of the first dose of vaccine is desirable. However, maternal antibodies may mitigate against early delivery of the first vaccine dose. Factors which could affect vaccine efficacy or safety include strain diversity, malnutrition, other enteric infections, parasitic infection or immune suppression. It was concluded that data from clinical trials conducted in one part of the world would not necessarily be predictive of vaccine efficacy in other places. It was agreed that in nonclinical evaluations there was a need to use oral dosing for toxicity studies and, because rotavirus is non-neurovirulent, that there was no need for an animal

  6. Stubborn rectal prolapse in systemic sclerosis.

    Science.gov (United States)

    Petersen, Sven; Tobisch, Alexander; Puhl, Gero; Kötter, Ina; Wollina, Uwe

    2017-01-01

    Systemic sclerosis (SSc) is an autoimmune connective tissue disorder. Anorectal involvement might typically cause fecal incontinence and rarely rectal prolapse. Here we report three female patients, who were admitted with a mean history of 10 years suffering from SSc. All patients presented with the initial symptom of anal incontinence, in all cases this was associated with rectal intussusception or rectal prolapse. The three women faced prolapse recurrence, independent of the initial procedure. After surgical removal of the prolapse, the incontinence remained. In SSc rectal prolapse syndrome might occur at an earlier age, and a primary prolapse of the ventral aspect of the rectal wall seems to be typical for this disease. If patients with prior diagnosis of SSc appear with third degree of fecal incontinence, it is suspected to be associated with rectal prolapse. The prolapse recurrence rate after surgery in SSc patients is high.

  7. Trichobezoars in baboons

    Science.gov (United States)

    Mejido, Diana C.P.; Dick, Edward J.; Williams, Priscilla C.; Sharp, R. Mark; Andrade, Marcia C.R.; DiCarlo, C.D.; Hubbard, Gene B.

    2009-01-01

    Background There is little information available concerning trichobezoars in the nonhuman primate literature. Methods We evaluated 118 cases of trichobezoar in baboons over a 29 year period at the Southwest National Primate Research Center. Results The anatomic locations affected in decreasing order were the stomach, small intestine, cecum, esophagus, and colon. The most common clinical history was weight loss. The most frequent associated pathology included gastrointestinal inflammation and ulceration, emaciation, peritonitis, intussusception, pneumonia, and aspiration. Trichobezoars were the cause of death in 9 baboons and the reason for euthanasia in 12. Females were 2.14 times more likely than males to be affected. The greater the percentage of group housing time, the more likely the baboon was to develop trichobezoars. Conclusions The baboon may present a useful model to evaluate the etiology, genetic predisposition, physiopathology, neurobiology, and treatment response of trichobezoars. PMID:19457157

  8. Perforated Meckel’s Diverticulum Lithiasis: An Unusual Cause of Peritonitis

    Directory of Open Access Journals (Sweden)

    Umasankar Mathuram Thiyagarajan

    2013-01-01

    Full Text Available Meckel’s diverticulum is the commonest congenital malformation of gastrointestinal tract and represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, it can present as bleeding, perforation, intestinal obstruction, intussusception, and tumours. These complications, especially bleeding, tend to be more common in the paediatric group and intestinal obstruction in adults. Stone formation (lithiasis in Meckel’s diverticulum is rare. We report a case of Meckel’s diverticulum lithiasis which presented as an acute abdomen in an otherwise healthy individual. The patient underwent an exploratory laparotomy which revealed a perforated Meckel’s diverticulum with lithiasis; a segmental resection with end-to-end anastomosis of small bowel was performed. Patient recovery was delayed due to pneumonia, discharged on day 20 with no further complications at 6 months following surgery.

  9. Surgery for a gastric Dieulafoy’s lesion reveals an occult bleeding jejunal diverticulum. A case report

    Science.gov (United States)

    2012-01-01

    Background Jejunal diverticulosis is an uncommon disease and usually asymptomatic. It can be complicated not only by diverticulitis, but by hemorrhage, perforation, intussusception, volvulus, malabsorption and even small bowel obstruction due to enteroliths formed and expelled from these diverticula. Methods We describe a case of an occult bleeding jejunal diverticulum, casually discovered in a patient that was taken to surgery for a Dieulafoy’s lesion after unsuccessful endoscopic treatment. We performed a gastric resection together with an ileocecal resection. Macroscopic and microscopic examinations confirmed the gastric Dieulafoy’s lesion and demonstrated the presence of another source of occult bleeding in asymptomatic jejunal diverticulum. Discussion The current case emphasizes that some gastrointestinal bleeding lesions, although rare, can be multiple and result in potentially life-threatening bleeding. The clinician must be mindful to the possibility of multisite lesions and to the correlation between results of the investigations and clinical condition of the bleeding patient. PMID:23173883

  10. Impact of rotavirus vaccines on rotavirus disease.

    Science.gov (United States)

    Lepage, Philippe; Vergison, Anne

    2012-05-01

    Rotaviruses are the most common cause of acute gastroenteritis in young children worldwide. Both licensed rotavirus vaccines (Rotarix™ [RV1] and RotaTeq™ [RV5]) are effective and safe. Studies from countries that have included RV1 or RV5 in the national immunization programs have demonstrated their safety and sustained efficacy under real-life circumstances. A significant decline in acute gastroenteritis-related deaths among Latin American children was observed after the introduction of RV1 and RV5 vaccines. Both vaccines were able to decrease the number of cases of rotavirus acute gastroenteritis and of severe rotavirus diseases. Vaccination was also associated with a dramatic reduction in hospitalizations and outpatient visits for all-cause acute gastroenteritis. Indirect protection after infant mass vaccination has been strongly suggested. Moreover, postlicensure safety studies assessed rare adverse events (rates <1 in 50,000), such as intussusception.

  11. [Emergency endoscopy in children: experience of a digestive endoscopy department].

    Science.gov (United States)

    Pacchione, D; Mortilla, M G; Ricci, E; Bertoni, G; Conigliaro, R; Orsi, P; Bedogni, G; Lamborghini, A; Banchini, G

    1992-01-01

    Many changes and advances have been achieved in the last years, so that emergency endoscopy has now a definite role also in the diagnosis and treatment of diseases in childhood. In order to determinate main indications to endoscopic examination, and which are the most useful diagnostic and therapeutic measures that should be performed, we examined the records of 202 patients (aged 1 day-14 years) undergone emergency endoscopy from June 1979 to January 1990. Patients were referred to endoscopy because of foreign bodies or caustic ingestion, hematemesis, and in one patient a suspected intussusception. We didn't record any complication. Our study shows that emergency endoscopy has a definite role also in pediatric age and gives a diagnostic and therapeutic gain in the management of many diseases.

  12. Graded compression sonography of the colon in the diagnosis of polyps in pediatric patients.

    Science.gov (United States)

    Baldisserotto, Matteo; Spolidoro, José Vicente Noronha; Bahú, Maria da Graça Soares

    2002-07-01

    We report seven cases of juvenile polyps detected by graded compression gray-scale and color Doppler sonography in five children with nonspecific symptoms. Intestinal polyps can be detected by graded compression gray-scale and color Doppler sonography without colonic preparation. On gray-scale sonography, polyps appeared as spherical or ovoid hypoechoic nodules in the colon lumen. Small cysts were identified inside the nodules. Four polyps had fewer and smaller cysts, whereas three others contained many cysts. A hyperechoic layer surrounding the polyp corresponded to the submucosa. In two patients, the polyp was visualized in the transverse colon and caused a colocolic intussusception, which reduced spontaneously during sonography. Color Doppler sonography showed four hypovascularized and three hypervascularized polyps.

  13. Maltomas and emergency surgery in children

    Directory of Open Access Journals (Sweden)

    Baeza Herrera Carlos

    2014-07-01

    Full Text Available The MALT tumor or maltoma, is a lymphoma type not yet well defined because it seems to be from the lymphatic tissue, but it is not included in that variety. It is more common in adults, the most frequent location is in the stomach. In children this tumor located in the small intestine is rare. We report our surgical experience in three patients who had a MALT tumor located one in the mucosa of the ileum and two in the serosa and mesentery of the small in- testine. Each one had a complication: intussusceptions, bleeding, bowel obstruction. They had to be operated urgently. All three patients are alive, two under surveillance and one under chemotherapy.

  14. Severe acute abdomen caused by symptomatic Meckel's diverticulum in three children with trisomy 18.

    Science.gov (United States)

    Hayashi, Anri; Kumada, Tomohiro; Furukawa, Oki; Nozaki, Fumihito; Hiejima, Ikuko; Shibata, Minoru; Kusunoki, Takashi; Fujii, Tatsuya

    2015-10-01

    Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the gastrointestinal tract and often presents a diagnostic challenge. Patients with trisomy 18 frequently have MD, but the poor prognosis and lack of consensus regarding management for neonates has meant that precise information on the clinical manifestations in infants and children with MD is lacking. We describe the cases of three children with trisomy 18 who developed symptomatic MD. Intussusception was diagnosed in Patient 1, intestinal volvulus in Patient 2, and gastrointestinal bleeding in Patient 3. All three patients underwent surgical treatment and only the Patient 1 died due to pulmonary hypertensive crisis. The other two patients experienced no further episodes of abdominal symptoms. In patients with trisomy 18, although consideration of postoperative complications and prognosis after surgical treatment is necessary, symptomatic MD should carry a high index of suspicion in patients presenting with acute abdomen. © 2015 Wiley Periodicals, Inc.

  15. Rectal prolapse as initial clinical manifestation of colon cancer.

    Science.gov (United States)

    Chen, C-W; Hsiao, C-W; Wu, C-C; Jao, S-W

    2008-04-01

    Rectal prolapse as the initial clinical manifestation of colorectal cancer is uncommon. We describe the case of a 75-year-old woman who was diagnosed as having adenocarcinoma of the sigmoid colon after presenting with complete rectal prolapse. The tumor caused rectosigmoid intussusception and then it prolapsed out through the anus. She underwent rectosigmoidectomy and rectopexy. The postoperative course was uneventful. The relationship between colorectal cancer and rectal prolapse has not been clearly established. This case report describes an unusual presentation of colorectal cancer. It suggests that rectal prolapse can present as the initial symptom of colorectal cancer and may also be a presenting feature of the occult intra-abdominal pathology. The importance of adequate investigation such as colonoscopy should be emphasized in patients who develop a new onset of rectal prolapse.

  16. Anorectal function orientated surgery for rectal prolapse

    International Nuclear Information System (INIS)

    Takao, Yoshihiko; Tsujizuka, Kazuyuki; Kikuchi, Kiyoshi; Okuda, Makoto

    2007-01-01

    Until quite recently, rectal prolapse was regarded as being a simple condition to treat. Surgical control of the prolapse was largely regarded as a successful outcome. However, recent detailed clinical assessment indicate that many patients have a rectal prolapse which is successfully controlled by surgical operation, yet suffer severe symptoms of disordered defecation, which either persists, or develops as a result of operative treatment. Difficulty with rectal evacuation, persistent incontinence and continuing mucus discharge are recognized as important, despite successful repair of the prolapse itself. There are two major theory of the pathology; circumferential intussusception and sliding hernia. However, many other multifarious factors are concomitant with the condition. These factors often need to be balanced against one another. Usually, a single surgical procedure will not be able to solve the problems. Therefore, the choice of treatment tailored for the individual patient. (author)

  17. Soft tissue myoepithelial carcinoma metastatic to the cecum: highlighting an unusual metastatic pattern and the need for diagnostic awareness

    Directory of Open Access Journals (Sweden)

    Despoina Mourtzoukou

    2016-03-01

    Full Text Available Myoepithelial neoplasms of the soft tissues are a rare, heterogeneous group of tumors for which classification continues to evolve. While well defined within salivary glands, they can also arise in viscera and soft tissues, where diagnosis is challenging due to the lack of clinical and pathological familiarity. We present the case of a 36 year old man with myoepithelial carcinoma arising as a primary tumor within the soft tissues of the neck, which metastasized to the cecum, causing intussusception. This spindle cell neoplasm showed the classic S100 protein, smooth muscle actin and pancytokeratin-positive immunoprofile. Metastasis of myoepithelial carcinoma to the cecum has not been previously described, and coupled with the spindle cell morphology, may cause significant diagnostic difficulty in the absence of clinical familiarity, particularly as there is morphologic overlap with spindle cell neoplasms arising more commonly in gastrointestinal sites, including gastrointestinal stromal tumor, leiomyosarcoma and sarcomatoid carcinoma.

  18. Gastrointestinal complications of bariatric Roux-en-Y gastric bypass surgery

    International Nuclear Information System (INIS)

    Sandrasegaran, Kumaresan; Rajesh, Arumugam; Lall, Chandana; Maglinte, Dean D.; Gomez, Gerardo A.; Lappas, John C.

    2005-01-01

    Obesity is rapidly becoming the most important public health issue in USA and Europe. Roux-en-Y gastric bypass is now established as the gold standard for treating intractable morbid or super obesity. We reviewed the imaging findings following this surgery in 234 patients. In this pictorial essay we present the CT and upper gastrointestinal contrast study appearances of the expected postoperative anatomy as well as a range of abdominal complications. The complications are classified into leaks, fistula and obstruction. Postoperative gastric outlet and small bowel obstruction can be caused by anastomotic stenosis, mesocolic tunnel stenosis, adhesions, stomal ulcer, obturation, intussusception and internal or external hernia. Small bowel obstruction may be of a simple, closed loop and/or strangulating type. The radiologist should be able to diagnose the type and possible cause of obstruction. (orig.)

  19. Gastrointestinal complications of bariatric Roux-en-Y gastric bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Sandrasegaran, Kumaresan; Rajesh, Arumugam; Lall, Chandana; Maglinte, Dean D. [Indiana University Medical Center, UH 0279, Department of Radiology, Indianapolis, IN (United States); Gomez, Gerardo A. [Wishard Memorial Hospital, Department of Surgery, Indianapolis (United States); Lappas, John C. [Wishard Memorial Hospital, Department of Radiology, Indianapolis (United States)

    2005-02-01

    Obesity is rapidly becoming the most important public health issue in USA and Europe. Roux-en-Y gastric bypass is now established as the gold standard for treating intractable morbid or super obesity. We reviewed the imaging findings following this surgery in 234 patients. In this pictorial essay we present the CT and upper gastrointestinal contrast study appearances of the expected postoperative anatomy as well as a range of abdominal complications. The complications are classified into leaks, fistula and obstruction. Postoperative gastric outlet and small bowel obstruction can be caused by anastomotic stenosis, mesocolic tunnel stenosis, adhesions, stomal ulcer, obturation, intussusception and internal or external hernia. Small bowel obstruction may be of a simple, closed loop and/or strangulating type. The radiologist should be able to diagnose the type and possible cause of obstruction. (orig.)

  20. Henoch-Schönlein purpura in children

    Science.gov (United States)

    Bluman, Joel; Goldman, Ran D.

    2014-01-01

    Abstract Question A child recently presented to my office with lower limb petechiae, arthralgia, and abdominal pain characteristic of Henoch-Schönlein purpura (HSP). Will systemic corticosteroids help relieve these symptoms and prevent potential HSP complications such as intussusception and nephritis? Answer Henoch-Schönlein purpura is a common and self-limiting disease in children. Current evidence does not support universal treatment of HSP with corticosteroids. Recent trials and meta-analyses found that corticosteroids do not prevent the onset of renal disease or abdominal complications. However, corticosteroids are effective as treatment of abdominal pain, arthralgia, and purpura. Clinicians are advised to use their discretion in choosing which patients might benefit most from oral corticosteroid treatment. PMID:25551129

  1. Henoch-Schönlein purpura in children: limited benefit of corticosteroids.

    Science.gov (United States)

    Bluman, Joel; Goldman, Ran D

    2014-11-01

    A child recently presented to my office with lower limb petechiae, arthralgia, and abdominal pain characteristic of Henoch-Schönlein purpura (HSP). Will systemic corticosteroids help relieve these symptoms and prevent potential HSP complications such as intussusception and nephritis? Henoch-Schönlein purpura is a common and self-limiting disease in children. Current evidence does not support universal treatment of HSP with corticosteroids. Recent trials and meta-analyses found that corticosteroids do not prevent the onset of renal disease or abdominal complications. However, corticosteroids are effective as treatment of abdominal pain, arthralgia, and purpura. Clinicians are advised to use their discretion in choosing which patients might benefit most from oral corticosteroid treatment.

  2. Acute Appendicitis in Henoch-Schönlein Purpura : A Case Report

    Science.gov (United States)

    Chung, Hae Yul; Kim, So Youn; Kim, Young Ok; Ryu, Seong Yeob; Kim, Jung Chul; Chung, Jae Hun

    2005-01-01

    Common complications of Henoch-Schönlein purpura (HSP) that lead to surgical intervention include intussusception, perforation, necrosis, and massive gastrointestinal bleeding. Acute appendicitis is rarely seen as a complication of HSP. A seven-year-old boy was admitted for arthralgia, abdominal pain, hematochezia, melena, and purpuric rash on the lower extremities. On admission day abdominal ultrasonography was normal, but on day 5, he became pyrexial and developed right iliac fossa pain and tenderness with guarding. Ultrasonography showed distended appendix surrounded by hyperechoic inflamed fat. On exploration an acutely inflamed, necrotic appendix was removed and grossly there was an appendiceal perforation in the appendiceal tip. Microscopically some of the small blood vessels in the submucosa showed fibrinoid necrosis with neutrophilic infiltrations. The authors report the case of a child who developed acute perforative appendicitis requiring appendectomy while on treatment for HSP. PMID:16224172

  3. Pathological study on treated and untreated dogs dead after γ-irradiation with 6 Gy

    International Nuclear Information System (INIS)

    Wang Dewen; Guan Mingchen; Liu Xuetong

    1986-01-01

    Forty dogs γ-irradiated with 6 Gy were divided into three groups: control (8 cases), treated with antibiotics alone (8 cases) and with combined measures (24 cases). The death of dogs in these groups occurred between 8th-12th, 11th-14th and 12th-169th days after irradiation respectively. In the third group, regeneration of hematopoietic cells in sternal bone marrow was first observed in dog dead on 17.5th day after irradiation, and regeneration of lymphoid tissues in spleen on 14th day. The degree of recovery in both of these organs was worse than in dogs irradiated with 3.25 Gy. The complications were varied; for instance, in addition to infection and hemorrhage, there were intussusception, gastric dilation, necrosis and hemorrhage of pancrease, jaundice, cerebral edema, hemorrhage and hernia, cachexia during recovery and so on. The causes of death in these experimental animals were also varied

  4. Small Bowel Obstruction Caused by Aloe vera Bezoars: A Case Report.

    Science.gov (United States)

    Hong, In Taik; Cha, Jae Myung; Ki, Hye Jin; Kwak, Min Seob; Yoon, Jin Young; Shin, Hyun Phil; Jeoun, Jung Won; Choi, Sung Il

    2017-05-25

    Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT. Phytobezoars should be included in the differential diagnosis of small bowel obstruction in patients with predisposing factors, such as excessive consumption of high-fiber food and diabetes.

  5. Radiologist's perspective for the Meckel's diverticulum and its complications

    Science.gov (United States)

    Kotha, V K; Saboo, S S; Shanbhogue, A K P; Virmani, V; Marginean, E C; Menias, C O

    2014-01-01

    The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation. PMID:24611767

  6. Laparoscopic rectopexy for solitary rectal ulcer syndrome without overt rectal prolapse. A case report and review of the literature.

    Science.gov (United States)

    Menekse, Ebru; Ozdogan, Mehmet; Karateke, Faruk; Ozyazici, Sefa; Demirturk, Pelin; Kuvvetli, Adnan

    2014-01-01

    Solitary rectal ulcer syndrome is a rare clinical entity. Several treatment options has been described. However, there is no consensus yet on treatment algorithm and standard surgical procedure. Rectopexy is one of the surgical options and it is generally performed in patients with solitary rectal ulcer accompanied with overt prolapse. Various outcomes have been reported for rectopexy in the patients with occult prolapse or rectal intussusception. In the literature; outcomes of laparoscopic non-resection rectopexy procedure have been reported in the limited number of case or case series. No study has emphasized the outcomes of laparoscopic non-resection rectopexy procedure in the patients with solitary rectal ulcer without overt prolapse. In this report we aimed to present clinical outcomes of laparoscopic non-resection posterior suture rectopexy procedure in a 21-year-old female patient with solitary rectal ulcer without overt prolapse.

  7. Laparoscopic rectopexy for solitary rectal ulcer syndrome without overt rectal prolapse: a case report and review of the literature.

    Science.gov (United States)

    Menekse, Ebru; Ozdogan, Mehmet; Karateke, Faruk; Ozyazici, Sefa; Demirturk, Pelin; Kuvvetli, Adnan

    2014-02-20

    Solitary rectal ulcer syndrome is a rare clinical entity. Several treatment options has been described. However, there is no consensus yet on treatment algorithm and standard surgical procedure. Rectopexy is one of the surgical options and it is generally performed in patients with solitary rectal ulcer accompanied with overt prolapse. Various outcomes have been reported for rectopexy in the patients with occult prolapse or rectal intussusception. In the literature; outcomes of laparoscopic non-resection rectopexy procedure have been reported in the limited number of case or case series. No study has emphasized the outcomes of laparoscopic non-resection rectopexy procedure in the patients with solitary rectal ulcer without overt prolapse. In this report we aimed to present clinical outcomes of laparoscopic non-resection posterior suture rectopexy procedure in a 21-year-old female patient with solitary rectal ulcer without overt prolapse.

  8. Potential safety issues and other factors that may affect the introduction and uptake of rotavirus vaccines

    Science.gov (United States)

    Aliabadi, N.; Tate, J.E.; Parashar, U.D.

    2018-01-01

    Rotavirus vaccines have demonstrated significant impact in reducing the burden of morbidity and mortality from childhood diarrhoea in countries that have implemented routine vaccination to date. Despite this success, in many countries, rotavirus vaccine coverage remains lower than that of other routine childhood vaccines. Several issues may potentially affect vaccine uptake, namely safety concerns related to intussusception with consequent age restrictions on rotavirus vaccination, contamination with porcine circovirus, vaccine-derived reassortant strains and hospitalization in newborn nurseries at time of administration of live oral rotavirus vaccine. In addition to these safety concerns, other factors may also affect uptake, including lower vaccine efficacy in the developing world, potential emergence of strains escaping from vaccine protection resulting in lower overall impact of a vaccination programme and sustainable vaccine financing. Although further work is needed to address some of these concerns, global policy bodies have reaffirmed that the benefits of rotavirus vaccination outweigh the risks, and vaccine use is recommended globally. PMID:27129416

  9. Retrospective detection by negative contrast electron microscopy of faecal viral particles in free-living wild red squirrels (Sciurus vulgaris) with suspected enteropathy in Great Britain.

    Science.gov (United States)

    Everest, D J; Stidworthy, M F; Milne, E M; Meredith, A L; Chantrey, J; Shuttleworth, C; Blackett, T; Butler, H; Wilkinson, M; Sainsbury, A W

    2010-12-25

    Transmission electron microscopy identified adenovirus particles in 10 of 70 (14.3 per cent) samples of large intestinal content collected at postmortem examination from free-living wild red squirrels (Sciurus vulgaris) across Great Britain between 2000 and 2009. Examination was limited to cases in which an enteropathy was suspected on the basis of predetermined macroscopic criteria such as semi-solid or diarrhoeic faeces, suspected enteritis or the presence of intussusception. In most cases, meaningful histological examination of enteric tissue was not possible due to pronounced autolysis. Two (2.9 per cent) of the samples were negative for adenovirus but were found to contain rotavirus particles, a novel finding in this species.

  10. Henoch-Schönlein Purpura

    DEFF Research Database (Denmark)

    Hetland, Liv Eline; Susrud, Kjærsti Sørensen; Lindahl, Kim Hein

    2017-01-01

    to arise from IgA depositions in blood vessel walls in the affected organs, mostly skin, gastrointestinal tract, joints and kidneys. Corticosteroids may be effective in rapid resolution of renal manifestations and treating joint and abdominal pain, but they are not proven effective for treating organ......Henoch-Schönlein purpura is the most common childhood vasculitis, but may also affect adults. This article reviews the literature since 2011 on advances in diagnosis, clinical disease manifestations, pathophysiology and treatment of Henoch-Schönlein purpura. The clinical manifestations are thought...... manifestations and complications, such as glomerulonephritis, bowel infarction or intussusception. Mycophenolate mofetil or cyclosporine A may be better treatment choices in case of renal involvement. Other immunosuppressive and immunomodulating drugs, such as rituximab and dapsone, are promising, but larger...

  11. Videodefaecography combined with measurement of the anorectal angle and of perineal descent

    International Nuclear Information System (INIS)

    Skomorowska, E.; Henrichsen, S.; Christiansen, J.; Hegedues, V.; Glostrup Sygehus, Copenhagen

    1987-01-01

    Cineradiographic defaecography combined with measurement of the anorectal angle and descent of the pelvic floor is proposed. The method used in 73 women gave valuable information in 48 patients who complained of anal incompetence, rectal tenesmus, and chronic constipation. In these patients, high and low rectal intussusception, rectocele, and pathologic movement of the pelvic floor were detected. Some of these phenomena could only be diagnosed by the radiologic method here described. Quantitations of the anorectal angle and descent of the pelvic floor placed the group with constipation halfway between normal individuals and those with anal incompetence. The value of this finding is discussed. Recent improvements in anorectal surgery often make videodefaecography decisive for the choice of the optimal operative method. Therefore, videodefaecography together with measurement of the anorectal angle and pelvic floor descent is recommended whenever anorectal surgery for correction of functional disturbances is contemplated. (orig.)

  12. Qualitative assessment of anorectal junction levels and anorectal angles to investigate functional differences between constipation and fecal incontinence

    International Nuclear Information System (INIS)

    Shannon, S.I.; Somers, S.; Anvari, M.; Stevenson, G.W.; Waterfall, W.E.; Huizinga, J.D.

    1989-01-01

    Female patients consecutively referred for defecography, with either chronic constipation or incontinence, were assessed for posterior anorectal angle and anorectal junction level as measured from the ischial tuberosities. The clinical groups did not differ in grades of rectoceles, enteroceles, or intussusception. Both constipated and incontinent patients had a low resting anorectal junction position compared with that of volunteers, indicating a stretched pelvic floor. Despite this, the constipated patients achieved a similar degree of lift of the pelvic floor on squeezing as controls, and they also showed significant angle changes on lifting and straining. Incontinent patients showed a significantly smaller amount of lift than controls, a significantly larger descent than constipated patients, and no angle changes on lifting and straining. These data are consistent with significantly weaker pelvic floor muscles in incontinent compared with constipated patients, despite a similar degree of stretching

  13. Evacuation proctography - examination technique and method of evaluation

    International Nuclear Information System (INIS)

    Braunschweig, R.; Schott, U.; Starlinger, M.

    1993-01-01

    Evacuation proctography is the most important imaging technique to supplement findings of physical examination, manometry, and endoscopy in patients presenting with pathologies in anorectal morphology and function. Indications for evacuation proctography include obstructed defecation or incomplete evacuation, imaging of ileal pouches following excision of the rectum, and suspected anorectal fistulae. Evacuation proctography with thick barium sulfate is performed under fluoroscopy. Documentation of the study can either be done by single-shot X-rays, video recording, or imaging with a 100-mm spot-film camera. Evacuation proctography shows morphologic changes such as spastic pelvic floor, rectocele, enterocele, intussusception and anal prolapse. Measurements can be performed to obtain the anorectal angle, location and mobility of the pelvic floor, and size as well as importance of a rectocele. Qualitative and quantitative data can only be interpreted along with clinical and manometric data. (orig.) [de

  14. Intravenous paracetamol overdose: two case reports and a change to national treatment guidelines.

    Science.gov (United States)

    Beringer, Richard M; Thompson, John P; Parry, Sarah; Stoddart, Peter A

    2011-03-01

    Two cases of 10-fold accidental overdose with intravenous paracetamol are presented. Case 1: A 5-month-old child with intussusception received 90 mg/kg intravenous paracetamol over an 8 h period. She was not initially treated with an antidote and developed hepatic impairment. Case 2: A 6-month-old child received a single dose of 75 mg/kg intravenous paracetamol. The child was treated with N-acetylcysteine and remained well without hepatic impairment. Therapeutic errors such as 10-fold overdosing are relatively common in children. Case 1 demonstrates that intravenous paracetamol is a potentially dangerous drug. This should be taken into consideration when prescribing the intravenous formulation. The concentration-time nomogram used following oral paracetamol overdose should be used with caution following intravenous overdose. Significant overdose should be discussed with the National Poisons Information Service whose guidance suggests intervention with antidote following an overdose above 60 mg/kg.

  15. Cinedefecographic findings in patients with obstructed defecation sindrome. A study in 420 cases.

    Science.gov (United States)

    Renzi, A; Izzo, D; Di Sarno, G; De Iuri, A; Bucci, L; Izzo, G; Di Martino, N

    2006-12-01

    Obstructed defecation syndrome (ODS) represents a very common clinical problem. The aim of this study was to analyze the cinedefecographic findings in a group of patients with ODS. All patients with ODS were prospectively introduced into a database and underwent cinedefecography (CD). The grade of the syndrome was assessed by a new ODS score. The validated Agachan-Wexner Constipation Score System was also used. Four lateral films were taken during resting, squeeze, pushing and postevacuation phases and puborectalis length (PRL), anorectal angle (ARA) and perineal descent were recorded and analysed. The presence of an increased fixed perineal descent (FPD) and dynamic perineal descent (DPD), mucosal rectal prolapse (MRP), recto-rectal intussusception (RRI), recto-anal intussusception (RAI), rectocele (RE), enterocele (ET) and sigmoidocele (SG) were also evaluated. Between February 2002 and March 2005, 420 patients, 404 (96.1%) females and 16 (3.8%) males with a mean age of 49+/-7.7 (range, 21-77) years, underwent CD. In 362 (86.2%) patients CD showed a combination of different cinedefecographic findings. RE, FPD and DPD in association with RAI or RRI were contemporary observed in 118 (26%) patients. MRP, RRI, FPD, RAI and RE were observed as singular finding in 21 (5%), 19 (4.5%), 12 (2.8%), 3 (0.7%) and 3 (0.7%) patients, respectively. In 6 (1.4%) patients a paradoxical contraction of the puborectalis muscle was observed. CD shows that ODS is largely caused by multiple patterns of different abnormalities of the rectum and pelvic floor. Any treatment in symptomatic patients could be designed to treat multiple combinations of different abnormalities.

  16. Uptake of oral rotavirus vaccine and timeliness of routine immunization in Brazil’s National Immunization Program

    Science.gov (United States)

    Flannery, Brendan; Samad, Samia; de Moraes, José Cássio; Tate, Jacqueline E.; Danovaro-Holliday, M. Carolina; de Oliveira, Lúcia Helena; Rainey, Jeanette J.

    2015-01-01

    Introduction In March, 2006, oral rotavirus vaccine was added to Brazil’s infant immunization schedule with recommended upper age limits for initiating (by age 14 weeks) and completing (by age 24 weeks) the two-dose series to minimize age-specific risk of intussusception following rotavirus vaccination. Several years after introduction, estimated coverage with rotavirus vaccine (83%) was lower compared to coverage for other recommended childhood immunizations (≥94%). Methods We analyzed data from Brazil’s national immunization program on uptake of oral rotavirus vaccine by geographic region and compared administrative coverage estimates for first and second doses of oral rotavirus vaccine (Rota1 and Rota2) with first and second doses of diphtheria-tetanus-pertussis-Haemophilus influenzae type b vaccine (DTP-Hib1 and DTP-Hib2). For 27 Brazilian cities, we compared differences between estimated rotavirus and DTP-Hib coverage in 2010 with delayed receipt of DTP-Hib vaccine among a cohort of children surveyed before rotavirus introduction. Results In 2010, infant vaccination coverage was 99.0% for DTP-Hib1 versus 95.2% for Rota1 (3.8% difference), and 98.4% for DTP-Hib2 versus 83.0% for Rota2 (15.4% difference), with substantial regional variation. Differences between DTP-Hib and rotavirus vaccination coverage in Brazilian cities correlated with delay in DTP-Hib vaccination among children surveyed. Age restrictions for initiating and completing the rotavirus vaccination series likely contributed to lower coverage with rotavirus vaccine in Brazil. Conclusion To maximize benefits of rotavirus vaccination, strategies are needed to improve timeliness of routine immunizations; monitoring rotavirus vaccine uptake and intussusception risk is needed to guide further recommendations for rotavirus vaccination. PMID:23313652

  17. Clinical characteristics and STK11 gene mutations in Chinese children with Peutz-Jeghers syndrome.

    Science.gov (United States)

    Huang, Zhiheng; Miao, Shijian; Wang, Lin; Zhang, Ping; Wu, Bingbing; Wu, Jie; Huang, Ying

    2015-11-25

    Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant inherited disease characterized by gastrointestinal hamartomatous polyps and mucocutaneous melanin spots. Germline mutation of the serine/threonine kinase 11 (STK11) gene are responsible for PJS. In this study, we investigated the clinical characteristics and molecular basis of the disease in Chinese children with PJS. Thirteen children diagnosed with PJS in our hospital were enrolled in this study from 2011 to 2015, and their clinical data on polyp characteristics, intussusceptions events, family histories, etc. were described. Genomic DNA was extracted from whole-blood samples from each subject, and the entire coding sequence of the STK11 gene was amplified by polymerase chain reaction and analyzed by direct sequencing. The median age at the onset of symptoms was 2 years and 4 months. To date, these children have undergone 40 endoscopy screenings, 17 laparotomies and 9 intussusceptions. Polyps were found in the stomach, duodenum, small bowel, colon and rectum, with large polyps found in 7 children. Mutations were found in eleven children, including seven novel mutations (c.481het_dupA, c.943_944het_delCCinsG, c.397het_delG, c.862 + 1G > G/A, c.348_349het_delGT, and c.803_804het_delGGinsC and c.121_139de l19insTT) and four previously reported mutations (c.658C > C/T, c.890G > G/A, c.1062 C > C/G, and c.290 + 1G > G/A). One PJS patient did not have any STK11 mutations. The polyps caused significant clinical consequences in children with PJS, and mutations of the STK11 gene are generally the cause of PJS in Chinese children. This study expands the spectrum of known STK11 gene mutations.

  18. Paediatric active enhanced disease surveillance: a new surveillance system for Australia.

    Science.gov (United States)

    Zurynski, Yvonne; McIntyre, Peter; Booy, Robert; Elliott, Elizabeth J

    2013-07-01

    The Paediatric Active Enhanced Disease Surveillance (PAEDS) is described. PAEDS is active in four tertiary children's hospitals in four states of Australia and aims to address gaps in surveillance for severe vaccine-preventable diseases and adverse events following immunisation. From August 2007 to December 2010, surveillance nurses actively identified and recruited children admitted with: acute flaccid paralysis, varicella infection, intussusception, seizures in infants and pandemic influenza (June-October 2009). Details of presentation, medical and immunisation history, outcome and laboratory results were collected. Completeness of ascertainment was estimated through audits of International Classification of Diseases 10th edition-coded medical records where possible. Seven hundred thirty-three cases matching case definition criteria for the four conditions were recruited. In addition, 601 cases of influenza were recruited during the 2009 pandemic. PAEDS enhanced acute flaccid paralysis surveillance by the Australian Paediatric Surveillance Unit; the World Health Organization surveillance target was met when Australian Paediatric Surveillance Unit and PAEDS cases were combined. Among 133 children hospitalised for varicella, only 16 were vaccinated; samples of vesicle scrapings were collected in 57% for genotyping. Of 122 infants presenting with seizures, only six (12%) had received a vaccine in the last 7 days. Intussusception was more frequent among infants receiving their first dose of either of the rotavirus vaccines. Results informed policy and education for parents and health professionals. Preliminary audits of medical records suggest excellent ascertainment through PAEDS. PAEDS provides important, previously unavailable data to inform public health policy, clinical practice and community confidence. It has potential to respond quickly during outbreaks and epidemics. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child

  19. Laparoscopic radical nephroureterectomy: dilemma of the distal ureter.

    Science.gov (United States)

    Steinberg, Jordan R; Matin, Surena F

    2004-03-01

    Laparoscopic nephroureterectomy has recently emerged as a safe, minimally invasive approach to upper tract urothelial cancers. The most controversial and challenging feature of laparoscopic nephroureterectomy is the management of the distal ureter. We review the most common methods of managing the distal ureter, with emphasis on contemporary oncologic outcomes, indications, advantages, and disadvantages. There are currently in excess of five different approaches to the lower ureter. These techniques often combine features of endoscopic, laparoscopic, or open management. They include open excision, a transvesical laparoscopic detachment and ligation technique, laparoscopic stapling of the distal ureter and bladder cuff, the "pluck" technique, and ureteral intussusception. Each technique has distinct advantages and disadvantages, differing not only in technical approach, but oncological principles as well. While the existing published data do not overwhelmingly support one approach over the others, the open approach remains one of the most reliable and oncologically sound procedures. The principles of surgical oncology dictate that a complete, en-bloc resection, with avoidance of tumor seeding, remains the preferred treatment of all urothelial cancers. The classical open technique of securing the distal ureter and bladder cuff achieves this principle and has withstood the test of time. Transvesical laparoscopic detachment and ligation is an oncologically valid approach in patients without bladder tumors, but is limited by technical considerations. The laparoscopic stapling technique maintains a closed system but risks leaving behind ureteral and bladder cuff segments. Both transurethral resection of the ureteral orifice (pluck) and intussusception techniques should be approached with caution, as the potential for tumor seeding exists. Additional long-term comparative outcomes are needed to solve the dilemma of the distal ureter.

  20. Comparing the Outcomes of Stapled Transanal Rectal Resection, Delorme Operation and Electrotherapy Methods Used for the Treatment of Obstructive Defecation Syndrome

    Directory of Open Access Journals (Sweden)

    Neda Mirabi

    2014-09-01

    Full Text Available Background: Pathophysiology and treatment of obstructive defecation syndrome (ODS remains to be defined clearly. Rectal hidden intussusceptions and voluminous hemorrhoids may be the cause. Where conservative treatment is not effective, ODS can be treated by STARR or Delorme operation. In some patients treatment of advance hemorrhoidal disease may resolve the syndrome. Methods: 81 females out of 183 ODS patients were selected for the treatment by Delorme, STARR or 30 mAmp electrotherapy. Results: The number of patients treated by STARR, Delorme and Electrotherapy were 34, 31 and 16, with mean postoperative pain ranking of 2.5, 3.7 and 1.5 and mean hospital stay of 2.3, and 3.2 and 1 day respectively. Mean ODS score, preoperatively compared with one-year post operation, improved from 14.5 to 5.1 (P=0.005 in STARR, 13.8 to 4.3 (P=0.006 in Delorme and 14.2 to 12.8 (P=0.725 in electrotherapy groups. The mean severity score (SS changed from 14.2, 15.18 and 13.90 preoperatively to 3.8, 4.12 and 11.34 postoperatively in all groups respectively. The mean resting pressures decreased from 82 to 65 in STARR (P=0.006, from 87 to 63 in Delorme (P=0.005 and from 79 to 74 mmHg (P=0.797 in electrotherapy groups. Postoperative defecography showed significant reduction in the intussusception parameter in STARR and Delorme (82.4% and 88% respectively; P<0.0001, but unchanged in electrotherapy group. Conclusion: STARR and Delorme are effective modalities for the treatment of patients with ODS, while STARR is simpler, less invasive and less painful. Although, electrotherapy eradicates the voluminous hemorrhoids but is ineffective in the treatment of ODS.

  1. Acute mechanical intestinal obstruction in children at zinder national hospital, Niger: Aetiologies and prognosis

    Directory of Open Access Journals (Sweden)

    Harissou Adamou

    2017-01-01

    Full Text Available Background: To describe the aetiological and prognostic aspects of acute mechanical intestinal obstruction (AMIO in children at Zinder National Hospital (Niger. Materials and Methods: This was a cross-sectional study on a period to January 2013–June 2015. The database included all children under 15 years of age with a surgical diagnosis of mechanical intestinal obstruction. P < 0.05 was considered statistically significant for analysis. Results: AMIOs represent 21.78% (n = 78 of child digestive surgical emergencies (n = 358. Median age was 12 months (range: 1 day–15 years. Fifteen (19.23% were neonates and sixty children (76.92% had ≤60 months. The sex ratio (male/female was 2.8. The mean time from onset to presentation was 39.96 ± 36.22 h. Intussusception and strangulated hernias were the main causes of AMIO with, respectively, 43.59% (n = 34 and 29.48% (n = 23. Anorectal malformations represent 17.95% (n = 14 of cases of AMIO. Intestinal resection was made in 22.08% and colostomy in 19.23% of patients. The average length of hospital stay was 6.44 ± 4.30 days. The post-operative complications were recorded in 26 patients (33.33%, mostly surgical site infections. Overall mortality of AMIO was 15.38% (n = 12. It was higher in the neonates (33.33% (P = 0.032. Deaths were associated with delay of admission (P = 0.0005 and waiting time for surgery (P = 0.019. Conclusion: Intussusception and strangulated hernia are the most common cause of AMIO in children. Diagnostic and therapeutic delays, lack of paediatric intensive care and post-operative complications are prognostic factors.

  2. Indications and outcome of childhood preventable bowel resections in a developing country

    Directory of Open Access Journals (Sweden)

    Uchechukwu Obiora Ezomike

    2014-01-01

    Full Text Available Background: While many bowel resections in developed countries are due to congenital anomalies, indications for bowel resections in developing countries are mainly from preventable causes. The aim of the following study was to assess the indications for, morbidity and mortality following preventable bowel resection in our centre. Patients and Methods: Retrospective analysis of all cases of bowel resection deemed preventable in children from birth to 18 years from June 2005 to June 2012. Results: There were 22 preventable bowel resections with an age range of 7 days to 17 years (median 6 months and male:female ratio of 2.1:1. There were 2 neonates, 13 infants and 7 older children. The indications were irreducible/gangrenous intussusceptions (13, abdominal gunshot injury (2, gangrenous umbilical hernia (2, blunt abdominal trauma (1, midgut volvulus (1, necrotizing enterocolitis (1, strangulated inguinal hernia (1, post-operative band intestinal obstructions (1. There were 16 right hemicolectomies, 4 small bowel resections and 2 massive bowel resections. Average duration of symptoms before presentation was 3.9 days (range: 3 h-14 days. Average time to surgical intervention was 42 h for survivors and 53 h for non-survivors. Only 19% presented within 24 h of onset of symptoms and all survived. For those presenting after 24 h, the cause of delay was a visit to primary or secondary level hospitals (75% and ignorance (25%. Average duration of post-operative hospital stay is 14 days and 9 patients (41% developed 18 complications. Seven patients died (31.8% mortality which diagnoses were irreducible/gangrenous intussusceptions (5, necrotising enterocolitis (1, midgut volvulus (1. One patient died on the operating table while others had overwhelming sepsis. Conclusion: There is a high rate of morbidity and mortality in these cases of preventable bowel resection. Typhoid intestinal perforation did not feature as an indication for bowel resection in this

  3. Assessment of chronic constipation: colon transit time versus defecography

    International Nuclear Information System (INIS)

    Prokesch, R.W.; Breitenseher, M.J.; Kettenbach, J.; Herbst, F.; Maier, A.; Lechner, G.; Mahieu, P.

    1999-01-01

    Objective: The aim of this study was to determine the value of radiological colon transit time (CTT) measurements in relation to defecography (DFG) in chronically constipated patients. Materials and methods: In 30 patients with chronic constipation, total and segmental CTT was determined using radiopaque markers. In all of these patients defecography (DFG) was obtained. The patients were divided into three groups: In group I, 11 patients were classified with idiopathic constipation based on low stool frequency, normal DFG, or absence of symptoms of abnormal defecation. In group II, ten patients with rectal intussusception were diagnosed by DFG. In group III, there were nine patients with rectal prolapse or spastic pelvic floor syndrome, based on results of DFG. Results: Group I, idiopathic constipation (n=11), showed increased total CTT (mean, 93 h) and segmental CTT (right colon, 33 h (36%), left colon, 31 h (33%), rectosigmoid, 29 h (31%)). In group II, intussusception (n=10), patients had normal mean total CTT (54 h) and a relative decrease in rectosigmoid CTT (mean, 13 h (24%)). In group III (n=9), rectal prolapse (n=5) or spastic pelvic floor syndrome (n=4), patients showed elevated total (mean, 167 h) and rectosigmoidal CTT (mean, 95 h (57%)). Mean total CTT was significantly different between groups I and II and between groups II and III, and mean rectosigmoidal CTT was significantly different between all three groups (P<0.05). Conclusion: The use of total and rectosigmoidal CTT helps to identify the underlying pathophysiology of chronic constipation. Furthermore CTT helps to identify patients, who may benefit from DFG

  4. Assessment of chronic constipation: colon transit time versus defecography

    Energy Technology Data Exchange (ETDEWEB)

    Prokesch, R.W. E-mail: rupert.prokesch@univie.ac.at; Breitenseher, M.J.; Kettenbach, J.; Herbst, F.; Maier, A.; Lechner, G.; Mahieu, P

    1999-12-01

    Objective: The aim of this study was to determine the value of radiological colon transit time (CTT) measurements in relation to defecography (DFG) in chronically constipated patients. Materials and methods: In 30 patients with chronic constipation, total and segmental CTT was determined using radiopaque markers. In all of these patients defecography (DFG) was obtained. The patients were divided into three groups: In group I, 11 patients were classified with idiopathic constipation based on low stool frequency, normal DFG, or absence of symptoms of abnormal defecation. In group II, ten patients with rectal intussusception were diagnosed by DFG. In group III, there were nine patients with rectal prolapse or spastic pelvic floor syndrome, based on results of DFG. Results: Group I, idiopathic constipation (n=11), showed increased total CTT (mean, 93 h) and segmental CTT (right colon, 33 h (36%), left colon, 31 h (33%), rectosigmoid, 29 h (31%)). In group II, intussusception (n=10), patients had normal mean total CTT (54 h) and a relative decrease in rectosigmoid CTT (mean, 13 h (24%)). In group III (n=9), rectal prolapse (n=5) or spastic pelvic floor syndrome (n=4), patients showed elevated total (mean, 167 h) and rectosigmoidal CTT (mean, 95 h (57%)). Mean total CTT was significantly different between groups I and II and between groups II and III, and mean rectosigmoidal CTT was significantly different between all three groups (P<0.05). Conclusion: The use of total and rectosigmoidal CTT helps to identify the underlying pathophysiology of chronic constipation. Furthermore CTT helps to identify patients, who may benefit from DFG.

  5. Vaccine adverse events in a safety net healthcare system and a managed care organization.

    Science.gov (United States)

    Narwaney, Komal J; Breslin, Kristin; Ross, Colleen A; Shoup, Jo Ann; Wain, Kris F; Weintraub, Eric S; McNeil, Michael M; Hambidge, Simon J

    2017-03-01

    The Institute of Medicine, in a 2013 report, recommended that the Vaccine Safety Datalink (VSD) expand collaborations to include more diversity in the study population. Kaiser Permanente Colorado (KPCO), an established VSD site, partnered with Denver Health (DH), an integrated safety net healthcare system, to demonstrate the feasibility of integrating DH data within the VSD. Prior to incorporating the data, we examined the identification of specific vaccine associated adverse events (VAEs) in these two distinct healthcare systems. We conducted retrospective cohort analyses within KPCO and DH to compare select VAEs between the two populations. We examined the following associations between January 1, 2004 and December 31, 2013: Measles, Mumps, and Rubella (MMR) vaccine and febrile seizures in children 2years and younger, intussusception after rotavirus vaccine in infants 4-34weeks, syncope after adolescent vaccines (Tetanus, Diphtheria, acellular Pertussis; Meningococcal and Human Papillomavirus) in adolescents 13-17years and medically attended local reactions after pneumococcal polysaccharide (PPSV23) vaccine in adults 65years and older. Both sites used similar data procurement methods and chart review processes. For seizures after MMR vaccine (KPCO - 3.15vs. DH - 2.97/10,000 doses) and syncope after all adolescent vaccines (KPCO - 3.0vs. DH - 2.37/10,000 doses), the chart confirmed rates were comparable at the two sites. However, for medically attended local reactions after PPSV23, there were differences in chart confirmed rates between the sites (KPCO - 31.65vs. DH - 14.90/10,000 doses). For intussusception after rotavirus vaccine, the number of cases was too low to make a valid comparison (KPCO - 0vs. DH - 0.13/10,000 doses). We demonstrated that data on important targeted VAEs can be captured at DH and rates appear similar to those at KPCO. Work is ongoing on the optimal approach to assimilate DH data as a potential safety net healthcare system in the VSD

  6. The costs and effectiveness of large Phase III pre-licensure vaccine clinical trials.

    Science.gov (United States)

    Black, Steven

    2015-01-01

    Prior to the 1980s, most vaccines were licensed based upon safety and effectiveness studies in several hundred individuals. Beginning with the evaluation of Haemophilus influenzae type b conjugate vaccines, much larger pre-licensure trials became common. The pre-licensure trial for Haemophilus influenzae oligosaccharide conjugate vaccine had more than 60,000 children and that of the seven-valent pneumococcal conjugate vaccine included almost 38,000 children. Although trial sizes for both of these studies were driven by the sample size required to demonstrate efficacy, the sample size requirements for safety evaluations of other vaccines have subsequently increased. With the demonstration of an increased risk of intussusception following the Rotashield brand rotavirus vaccine, this trend has continued. However, routinely requiring safety studies of 20,000-50,000 or more participants has two major downsides. First, the cost of performing large safety trials routinely prior to licensure of a vaccine is very large, with some estimates as high at US$200 million euros for one vaccine. This high financial cost engenders an opportunity cost whereby the number of vaccines that a company is willing or able to develop to meet public health needs becomes limited by this financial barrier. The second downside is that in the pre-licensure setting, such studies are very time consuming and delay the availability of a beneficial vaccine substantially. One might argue that in some situations, this financial commitment is warranted such as for evaluations of the risk of intussusception following newer rotavirus vaccines. However, it must be noted that while an increased risk of intussusception was not identified in large pre-licensure studies, in post marketing evaluations an increased risk of this outcome has been identified. Thus, even the extensive pre-licensure evaluations conducted did not identify an associated risk. The limitations of large Phase III trials have also been

  7. Abdominal emergencies

    International Nuclear Information System (INIS)

    Raissaki, M.

    2012-01-01

    Full text: There are numerous conditions that affect mainly or exclusively the pediatric population. These constitute true emergencies, related to patient's health. Delay in diagnosis and treatment of abdominal non-traumatic emergencies may result in rapid deterioration, peritonitis, sepsis, even death or in severe complications with subsequent morbidity. Abdominal emergencies in children mostly present with pain, tenderness, occasionally coupled by vomiting, fever, abdominal distension, and failure to pass meconium or stools. Diarrhea, blood per rectum, abnormal laboratory tests and lethargy may also be manifestations of acute abdominal conditions. Abdominal emergencies have a different aetiology, depending on age and whether the pain is acute or chronic. Symptoms have to be matched with age and gender. Newborns up to 1 months of age may have congenital diseases: atresia, low obstruction including Hirschsprung's disease, meconium ileus. Meconium plug is one of the commonest cause of low obstruction in newborns that may also develop necrotizing enterocolitis, incarcerated inguinal hernia and mid-gut volvulus. Past the immediate postnatal period, any duodenal obstruction should be considered midgut volvulus until proven otherwise and patients should undergo ultrasonography and/or properly performed upper GI contrast study that records the exact position of the deduno-jejunal junction. Infants 6 months-2 years carry the risk of intussusception, mid-gut volvulus, perforation, acute pyelonephritis. Preschool and school-aged children 2-12 years carry the risk of appendicitis, genito-urinary abnormalities including torsion, urachal abnormalities, haemolytic uremic syndrome and Henoch-Schonlein purpura. Children above 12 years suffer from the same conditions as in adults. Most conditions may affect any age despite age predilection. Abdominal solid organ ultrasonography (US) coupled with gastrointestinal ultrasonography is the principle imaging modality in radiosensitive

  8. Prevalence, causes and management outcome of intestinal obstruction in Adama Hospital, Ethiopia.

    Science.gov (United States)

    Soressa, Urgessa; Mamo, Abebe; Hiko, Desta; Fentahun, Netsanet

    2016-06-04

    In Africa, acute intestinal obstruction accounts for a great proportion of morbidity and mortality. Ethiopia is one of the countries where intestinal obstruction is a major cause of morbidity and mortality. This study aims to determine prevalence, causes and management outcome of intestinal obstruction in Adama Hospital in Oromia region, Ethiopia. A hospital based cross-sectional study design was used. Data covering the past three years were collected from hospital medical records of sampled patients. The collected data were checked for any inconsistency, coded and entered into SPSS version 16.0 for data processing and analysis. Descriptive and logistic regression analyses were used. Statistical significance was based on confidence interval (CI) of 95 % at a p-value of acute abdomen surgery and total surgical admissions, respectively. The mortality rate was 2.5 % (6 of 262). The most common cause of small bowel obstruction was intussusceptions in 48 patients (30.9 %), followed by small bowel volvulus in 47 patients (30.3 %). Large bowel obstruction was caused by sigmoid volvulus in 60 patients (69.0 %) followed by colonic tumor in 12 patients (13.8 %). After controlling for possible confounding factors, the major predictors of management outcome of intestinal obstruction were: duration of illness before surgical intervention (adjusted odds ratio (AOR) = 0.49, 95 % CI: 0.25-0.97); intra-operative findings [Viable small bowel volvulus (SBV) (AOR = 0.08, 95 % CI: 0.01-0.95) and viable (AOR = 0.17, 95 % CI: 0.03-0.88)]; completion of intra-operative procedures (bowel resection & anastomosis (AOR = 3.05, 95 % CI: 1.04-8.94); and length of hospital stay (AOR = 0.05, 95 % CI: 0.01-0.16). Small bowel obstruction was more prevalent than large bowel obstruction. Intussusceptions and sigmoid volvulus were the leading causes of small and large bowel obstruction. Laparotomy was the most common methods of intestinal obstruction management. Bowel

  9. Monitoring and evaluating the physiological changes in the horse with acute abdominal disease.

    Science.gov (United States)

    Coffman, J R

    1975-03-01

    Initial examination and therapy, and the avoidance of maltreatment are emphasized. Gastric decompression is of prime importance, after which no compound should be administered via stomach tube. Where large amounts of high starch grains are fed, primary acute gastric dilatation must be differentiated from that secondary to small bowel dilatation, by immediate gastric intubation and irrigation of the cardia with lidocaine. If cessation of pain and improvement of peristalsis and general attitude follow, the former state may be assumed. If pain persists and peristalsis does not improve markedly, one should assume small bowel displacement. Rectal examination is helpful in initial evaluation: impactions, inguinal herniation and ileocaecal intussusception may be diagnosed and small bowel displacement suspected. Palpation of one or more distended loops of bowel in the ventral middle third of the abdomen indicates small bowel displacement or ileus and flaccid distension. Distinction by rectal palpation alone is difficult. Palpation of the gas-distended apex of the caecum in the middle third of the abdomen is virtually pathognomonic for 180 degrees rotation of the large bowel. Abdominal paracentesis yielding true sanguineous effusion indicates a necrotizing segment of the bowel. If negative, such a segment is absent, or there is an infarcted segment, not yet damaged to the point of leaching whole blood, or the necrotizing segment is outside the peritoneal cavity, i.e., in the thorax, intussuscepted into the caecum, or herniated into the inguinal canal. Recurrent colics frequently may be due to verminous arteritis but the relationship to diet should be investigated. Recurrent colics after grain ingestion with occult blood in the faeces may be due to ulcers; such cases respond well to grain withdrawal. The advantages and disadvantages of phenothiazine-derived tranquillizers are discussed. They are contra-indicated if there is any evidence of circulating volume insufficiency

  10. COMPARISON BETWEEN LAPAROSCOPIC SUTURE RECTOPEXY AND ALTEMEIER'S PROCEDURE FOR THE MANAGEMENT OF COMPLETE RECTAL PROLAPSE- A SINGLE CENTER RETROSPECTIVE OBSERVATIONAL STUDY

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    Balakrishna Nanjundappa Setty

    2017-05-01

    Full Text Available BACKGROUND Rectal prolapse is defined as protrusion of rectal wall through the anal canal. It is further classified into 3 different categories based on the extent of rectal prolapse called partial thickness (mucosal rectal prolapse when only the mucosa is prolapsed through the anal verge, complete rectal prolapse (procidentia involves full thickness of rectal wall prolapsing out of the anal verge and internal rectal prolapse (rectal intussusception involves intussusception of the rectum into the anal canal without protrusion beyond the anal verge. Rectal prolapse can be partial to begin with and may or may not progress to complete rectal prolapse. The aim of our study is to analyse and compare two surgical techniques laparoscopic suture rectopexy and Altemeier’s procedure available for the management of rectal prolapse along with the outcomes of both in a single centre. MATERIALS AND METHODS The study was conducted in Department of Surgical Gastroenterology, Bangalore Medical College and Research Institute, Karnataka. It’s a retrospective observational study conducted between August 2012 and May 2016. The presenting feature, intraoperative events, postoperative course, complications and follow up were noted with regard to faecal incontinence, constipation and recurrent prolapse. RESULTS A total of 35 patients were included in this study. The male-to-female ratio was 1.7:1. The presenting feature being intermittent rectal prolapse in 31 (88%, irreducible rectal prolapse in 2 (5.7% and 2 (5.7% patients were operated for recurrent rectal prolapse. The presenting symptom in the patients were constipation in 14 (40%, incontinence in 5 (14.28% and solitary rectal ulcer syndrome in 3 (8.6%. 20 patients (57.14% underwent laparoscopic suture rectopexy with conversion to open in two patients. 15 (42.8% patients underwent Altemeier’s procedure. The average total duration of hospital stay for patients with suture rectopexy was 3.05263 days and for

  11. Efficacy and safety of a pentavalent live human-bovine reassortant rotavirus vaccine (RV5) in healthy Chinese infants: A randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Mo, Zhaojun; Mo, Yi; Li, Mingqiang; Tao, Junhui; Yang, Xu; Kong, Jilian; Wei, Dingkai; Fu, Botao; Liao, Xueyan; Chu, Jianli; Qiu, Yuanzheng; Hille, Darcy A; Nelson, Micki; Kaplan, Susan S

    2017-10-13

    A randomized, double-blind, placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a pentavalent live human-bovine reassortant rotavirus vaccine (RotaTeq™, RV5) against rotavirus gastroenteritis (RVGE). 4040 participants aged 6-12weeks were enrolled and randomly assigned to either 3 oral doses of RV5 (n=2020) or placebo (n=2020), administered ∼4weeks apart. The participants also received OPV and DTaP in a concomitant or staggered fashion. The primary objective was to evaluate vaccine efficacy (VE) against naturally-occurring RVGE at least 14days following the third dose. Key secondary objectives included: VE against naturally-occurring severe RVGE and VE against severe and any-severity RVGE caused by rotavirus serotypes contained in the vaccine, occurring at least 14days after the third dose. All adverse events (AEs) were collected for 30days following each dose. Serious AEs (SAEs) and intussusception cases were collected during the entire study. (ClinicalTrials.gov registry: NCT02062385). VE against RVGE of any-severity caused by any serotype was 69.3% (95% CI: 54.5, 79.7). The secondary efficacy analysis showed an efficacy of: 78.9% (95% CI: 59.1, 90.1) against severe RVGE caused by any serotype; 69.9% (95% CI: 55.2, 80.3) and 78.9% (95% CI: 59.1, 90.1) against any-severity and severe RVGE caused by serotypes contained in the vaccine, respectively. Within 30days following any vaccination, 53.5% (1079/2015) and 53.3% (1077/2019) of participants reported at least one AE, and 5.8% (116/2015) and 5.7% (116/2019) reported SAEs in the vaccine and placebo groups, respectively. No SAEs were considered vaccine-related in recipients of RV5. Two intussusception cases were reported in recipients of RV5 who recovered after receiving treatment. Neither was considered vaccine-related. In Chinese infants, RV5 was efficacious against any-severity and severe RVGE caused by any serotype and generally well

  12. Pediatric Gastrointestinal Diseases in Nigeria: Histopathologic Analysis of 74 Cases

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    Abudu

    2013-10-01

    Full Text Available BACKGROUND: Children are vulnerable to a vast number of diseases including gastrointestinal disorders, which may be associated with life threatening complications that sometimes result in mortality especially if left untreated. OBJECTIVE: To establish the age and sex distribution of children in the study population as well as the histopathological characteristics of gastrointestinal diseases that occurred in those children who were aged 14years and below in Sagamu, Southwestern Nigeria. MATERIALS AND METHODS: Demographic data such as age, sex, and clinical summary of children in the study population were extracted from the medical records of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State from January 2003 to December 2009. Based on this information, a review of paraffin embedded blocks and slides as well as histopathological reports of gastrointestinal diseases that occurred in those children aged 14years and below was undertaken at the Morbid Anatomy Department of the hospital. RESULTS: Seventy–four cases of gastrointestinal diseases were seen in children aged 14years and below. The majority (39.2% of gastrointestinal diseases were accounted for by appendiceal lesions. Hirschsprung’s disease, intussusceptions, enterocolitis and jejunal atresia accounted for 29.7%, 10.8%, 6.8% and 4.1% of cases respectively. Adenocarcinoma of the intestine was the predominant gastrointestinal tumour, occurring in 5 out of 7 children. Two cases of non-Hodgkin lymphoma were also seen. The ages of the children ranged from 2 to 14 years, with a mean age of 8.6years and a peak age incidence of gastrointestinal disease in the 10-14year age group. Male children were more commonly affected with the exception of appendiceal lesions, which occurred more in females (M:F ratio= 1.6:1.0. Acute suppurative appendicitis was the most prevalent lesion of the appendix, occurring in 13 out of 29 appendiceal lesions. Moderately differentiated to poorly

  13. Nodular lymphoid hyperplasia of the intestinal tract in infancy and childhood.

    Science.gov (United States)

    Atwell, J D; Burge, D; Wright, D

    1985-02-01

    Over an 18-year period we have diagnosed nodular lymphoid polyposis of the intestinal tract in 6 patients. The site of the polyposis, which was due to prominent lymphoid hyperplasia, was ileal (3), colonic (2), and rectal (1). The diagnosis was made following complications arising from the polyps, which included recurrent intussusception (2), rectal prolapse (1), intestinal or pseudointestinal obstruction (2), and rectal bleeding (1). Immunoglobulin staining was performed on all the bowel specimens and in every case secretory IgA was present on the mucosal surfaces and IgG and IgA were seen in the lamina propria, thus excluding immunodeficiency in these patients. Viral studies were performed in 3 patients and all were positive. In one patient Echovirus II was seen in tissue homogenate from a mesenteric lymph node and in another, adenovirus type II was cultured from lymphoid polyps of the rectum. A further patient had positive serological tests for adenovirus. Thus it appears that nodular lymphoid hyperplasia is part of the generalized lymphoid hyperplasia associated with viral infections in infancy and childhood. Immunodeficiency states as a cause of the lymphoid hyperplasia should always be excluded by estimation of serum immunoglobulins.

  14. Transabdominal Ultrasonography of the Small Bowel

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    Rudolf Kralik

    2013-01-01

    Full Text Available In the era of double balloon enteroscopy, capsule endoscopy, CT, and MRI enterography is transabdominal ultrasonography (TUS underestimated method for evaluation of small bowel pathology. As often initial imagine method in abdominal complaints, nowadays has TUS much better diagnostic potential than two decades ago. High-resolution ultrasound probes with harmonic imaging significantly improve resolution of bowel wall in real time, with possibility to asses bowel peristalsis. Color flow doppler enables evaluation of intramural bowel vascularisation, pulse wave doppler helps to quantificate flow in coeliac and superior mesenteric arteries. Small intestine contrast ultrasonography with oral contrast fluid, as well as contrast enhanced ultrasonography with intravenous microbubble contrast also improves small bowel imaging. We present a review of small intestine pathology that should be detected during ultrasound examinations, discuss technical requirements, advantages and limitations of TUS, typical ultrasound signs of Crohn's disease, ileus, celiac disease, intussusception, infectious enteritis, tumours, ischemic and haemorrhagic conditions of small bowel. In the hands of experienced investigator, despite some significant limitations(obesity, meteorism, is transabdominal ultrasonography reliable, noninvasive and inexpensive alternative method to computerised tomography (CT and magnetic resonance imaging (MRI in small bowel examination.

  15. Feline alimentary lymphosarcoma: radiographic, ultrasonographic, histologic, and viral findings

    International Nuclear Information System (INIS)

    Hittmair, K.; Krebitz-Gressl, E.; Kuebber-Heiss, A.; Moestl, K.

    2000-01-01

    Sixty cats with clinical symptoms indicative of gastroin-testinal lymphosarcoma were examined radiographically and ultrasonographically. Clinical signs included lethargy, anorexia, weight loss, anemia, vomiting, diarrhea, and a palpable mid-abdominal mass. Radiographic findings with alimentary lymphosarcoma (LSA) showed diffuse decreased serosal detail, a mid-abdominal soft-tissue mass, cavernous lesions, and gas-filled bowel loops. Ultrasonographic features included marked stomach or intestinal wall thickening, loss of wall layering, decreased echogenicity, and a hyperechoic central reflection. Hypoechonic infiltration of mesenterial lymph nodes and other abdominal organs were visualized ultrasonographically. Alimentary LSA was diagnosed in thirty-six of the sixty cats. Ultrasonography was helpful in determining the cause of disease in the remaining twenty-four cats. Differential diagnosis included intussusception, foreign bodies, chronic gastroenteritis, granuloma (feline infectious peritonitis - FIP), and other gastrointestinal neoplasms. In ten of the thirty-six cats with alimentary lymphosarcoma, diagnosis was confirmed by ultrasound-guided fine-needle biopsies. Blood and/or saliva ELISA-tests determined feline leukemia virus or antigen in only eleven of the thirty-six cats. Histopathology revealed lymphoid infiltration of the stomach or intestinal wall in twenty-nine of the thirty-six cases. Additionally, the medical records of seventy-one cats with proven alimentary LSA were reviewed. Ultrasonographic findings showed intestinal LSA in sixty-two cats and LSA of the stomach in nine cats. Both studies indicate that ultrasonography is a valuable diagnostic tool for feline alimentary LSA. (author)

  16. Assessing colonic anatomy normal values based on air contrast enemas in children younger than 6 years.

    Science.gov (United States)

    Koppen, Ilan J N; Yacob, Desale; Di Lorenzo, Carlo; Saps, Miguel; Benninga, Marc A; Cooper, Jennifer N; Minneci, Peter C; Deans, Katherine J; Bates, D Gregory; Thompson, Benjamin P

    2017-03-01

    Contrast enemas with barium or water-soluble contrast agents are sometimes performed in children with severe intractable constipation to identify anatomical abnormalities. However there are no clear definitions for normal colonic size or abnormalities such as colonic dilation or sigmoid redundancy in children. To describe characteristics of colonic anatomy on air contrast enemas in children without constipation to provide normal values for colonic size ratios in children. We performed a retrospective chart review of children aged 0-5 years who had undergone air contrast enemas for intussusception. The primary outcome measures were the ratios of the diameters and lengths of predetermined colonic segments (lengths of rectosigmoid and descending colon; diameters of rectum, sigmoid, descending colon, transverse colon and ascending colon) in relation to the L2 vertebral body width. We included 119 children (median age 2.0 years, range 0-5 years, 68% boys). Colonic segment length ratios did not change significantly with age, although the differences for the rectosigmoid/L2 ratio were borderline significant (P = 0.05). The ratios that involved the rectal and ascending colon diameters increased significantly with age, while diameter ratios involving the other colonic segments did not. Differences by gender and race were not significant. These data can be used for reference purposes in young children undergoing contrast studies of the colon.

  17. Intestinal Obstruction in a 3-Year-Old Girl by Ascaris lumbricoides Infestation: Case Report and Review of the Literature.

    Science.gov (United States)

    Andrade, Angel Medina; Perez, Yeudiel; Lopez, Cecilia; Collazos, Stephanie Serrano; Andrade, Alejandro Medina; Ramirez, Grecia Ortiz; Andrade, Laura Medina

    2015-04-01

    Ascaris lumbricoides infection affects approximately 1.5 billion people globally. Children with environmental and socio-economic risk factors are more susceptible to infestation, with serious complications such as intestinal obstruction (IO), volvulus, intussusception, and intestinal necrosis.We present the case of a 3-year-old girl who arrived at emergency department with abdominal pain and diarrhea for the last 3 days. The previous day she took an unspecified anthelmintic. Symptoms worsened with vomiting and diarrhea, with expulsion of roundworms through mouth and anus. Physical examination revealed bloating, absence of bowel sounds, abdominal tenderness, and a palpable mass in right hemi-abdomen. Abdominal radiographs showed air-fluid levels with mild bowel distention and shadows of roundworms. The diagnosis of IO by A lumbricoides. infestation was established and surgical approach scheduled. During exploratory laparotomy an intraluminal bolus of roundworms from jejunum to ascendant colon was evident. An ileum enterotomy was performed and worms were removed. Fluid therapy and antibiotics for 72  hours were administered, with posterior albendazol treatment for 3 days. Patient was uneventfully discharged on the tenth day.Reduction in parasitic load by means of improvements in sanitation, health education, and anthelmintic treatment must be implemented in endemic zones to prevent serious life-threatening complications by A lumbricoides. infestation, because some of them require urgent surgical treatment.

  18. Gastrointestinal linear foreign bodies in 32 dogs: a retrospective evaluation and feline comparison

    International Nuclear Information System (INIS)

    Evans, K.L.; Smeak, D.D.; Biller, D.S.

    1994-01-01

    Hospital records of 32 dogs undergoing surgery for gastrointestinal linear foreign bodies (LFBs) were reviewed to evaluate clinical signs, laboratory abnormalities, radiographic signs, surgical procedures, andcomplications associated with this condition. Information potentiallyrelating to prognosis was evaluated statistically. Clinical data derived from this study was compared to the information available in the literature regarding LFBs in cats. Linear foreign bodies were rarely discovered under the tongue during physical examination of affected dogs(2/32; 6%), and most were lodged at the pylorus (28/32; 87%). The types of LFB removed were more variable in the dog; fabric, carpet, pantyhose, string, and plastic were the most common. Fabric and plastic materials had an increased probability of causing peritonitis. Peritonitis was evident at surgery in 13/32 (41%) dogs; of these, 9/32 (31%) hadgross contamination through intestinal perforations. Intestinal resection and anastomosis was required in 13/32 dogs (41%). Intussusceptions concurrently were found in 8/32 (25%) dogs having LFBs. The presenceof perforations or peritonitis increased the probability of death. The probability of peritonitis and death as a result of LFB in dogs is nearly double that of cats as described in previous reports

  19. Complicated Jejunal Diverticulosis: Small Bowel Volvulus with Obstruction

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    Rommel Singh Mohi

    2016-11-01

    Full Text Available The incidence of the diverticulum of the small bowel varies from 0.2-1.3% in autopsy studies to 2.3% when assessed on enteroclysis. It occurs mostly in patients in the 6th decade of their life. Of all the small bowel diverticuli, jejunal diverticulum is the most common type. This rare entity is usually asymptomatic. However, they may cause chronic non-specific symptoms for a long period of time like dyspepsia, chronic postprandial pain, nausea, vomiting, borborgymi, alternating diarrhoea and constipation, weight loss, anaemia, steatorrhea or rarely lead to complications like haemorrhage, obstruction, perforation. Obstruction can be due to enterolith, adhesions, intussusception, and volvulus. The condition is difficult to diagnose because patients are generally presented with symptoms that mimic other diseases. It is important for clinicians to have awareness of this entity. Here, we present a case of multiple jejunal diverticuli with a history of repeated attacks of diverticulitis over past 20 years, which were misdiagnosed and now presented with intestinal obstruction due to volvulus of the involved segment along with mesentery around its axis. Resection of the diverticuli segment of jejunum was done with end-to-end jejuno-jejunal anastomosis. The patient is asymptomatic since 10 months of follow-up.

  20. Complicated jejunal diverticulosis: A case report with literature review

    Science.gov (United States)

    Nejmeddine, Affes; Bassem, Abid; Mohamed, Hammami; Hazem, Ben ameur; Ramez, Beyrouti; Issam, Beyrouti Mohamed

    2009-01-01

    Context: Jejunal diverticuli are rare and usually asymptomatic. More commonly, they are seen as incidental findings on CT images, enteroclysis, or during surgery. Complications such as bleeding, perforation, obstruction, malabsorption, diverticulitis, blind loop syndrome, volvulus, and intussusceptions may warrant surgical intervention. Case report: We report a case of 47-year old woman who had suffered from intestinal obstruction for 3 days. The symptoms did not improve after conservative treatment. An exploratory laparotomy found small bowel obstruction due to proximal jejunal diverticulum with an adhesion epiploic band. Strangulation of the jejunum resulted from the internal hernia caused by the band. The band was removed and the proximal jejunum segmentally resected. The postoperative course was uneventful. Conclusion: Although this phenomenon is rare, we should keep in mind that intestinal diverticulosis may induce intestinal obstructions of different kinds, repeat physical examinations and X-ray films are needed and enteroclysis studies or CT scan are helpful in diagnosis. Surgery is indicated for acute abdominal or repeated intestinal obstruction. PMID:22666695

  1. Giant Meckel’s diverticulum torsion that mimics adnexal pathology

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    Serdar Kirmizi

    2016-01-01

    Full Text Available Meckel’s diverticulum is a real diverticulum located at the antimesenteric portion of intestinal loops and including all layers of the intestinal wall. It is the most common congenital anomaly of the gastrointestinal tract, and its incidence is 1–3%. Many asymptomatic cases are diagnosed when complications occur. A 23-year-old female patient applied to gynaecology emergency clinic with pelvic pain complaint. Laparotomy was performed with the diagnosis of acute abdomen because the physical examination and imaging studies did not exclude tuboovary pathology. Giant Meckel’s diverticulitis and ischemic bowel loops that had been torsion were observed. Obstruction is the most common complication and generally originates from inflammation, adhesions, intussusception and omphalo-mesenteric band. In this case, it was seen that mobilized diverticulitis can be complicated without any fibrous band or adhesion to adjacent organs. This case supports that there can be torsion of bowel in free Meckel’s diverticulum. Meckel’s diverticulum settled in the pelvic region can make a clinical manifestation that is difficult to distinguish from adnexal diseases. It should be kept in mind for cases that start with pelvic pain, form adnexal pathology suspicion and cause an acute abdomen.

  2. Small bowel obstruction in children: usefulness of CT for diagnosis and localization

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Cheol; Kim, Young Tong; Bae, Won Kyung; Kim, Il Young [Cheonan Hospital, Soonchunhyang University, Cheonan (Korea, Republic of)

    2007-12-15

    To evaluate the usefulness of CT for the diagnosis of the cause and localization of small bowel obstruction. Out of a group of children who underwent a CT examination for a suspected small bowel obstruction, 19 patients with confirmed underlying disorders were identified and included in the study. Neonates and patients with duodenal obstruction were excluded from the study. The CT findings were analyzed for the location of obstruction site, abnormalities of the mesentery and mesenteric vessels, bowel wall thickening, closed loop obstruction, and strangulation. The obstruction site was divided into five parts. The preoperative CT diagnosis was compared with the final diagnosis. Causes of small bowel obstruction were intussusception (n = 6), appendiceal perforation (n = 4), transmesenteric internal hernia (n = 2), postoperative bands (n = 1), idiopathic multiple bands (n = 1), a foreign body (n = 1), a small bowel adenocarcinoma (n = 1), Meckel's diverticulitis (n = 1), tuberculous peritonitis (n = 1) and Salmonella enteritis with bowel perforation (n = 1). The CT findings showed mesenteric vascular prominence (n = 13), omental or mesenteric infiltration (n = 10), localized bowel wall thickening (n = 7) closed loops obstruction (n = 3) and strangulation (n = 1). The obstruction site was identified in all cases. The causes of obstruction could be diagnosed preoperatively in 14 cases, but a preoperative diagnosis was difficult in 5 cases. The causes of small bowel obstruction in children are variable, and CT is useful for evaluating the cause and localization of small bowel obstruction.

  3. CLINICAL, EPIDEMIOLOGIC, AND ENDOSCOPIC PROFILE IN CHILDREN AND ADOLESCENTS WITH COLONIC POLYPS IN TWO REFERENCE CENTERS.

    Science.gov (United States)

    Andrade, Denise O; Ferreira, Alexandre Rodrigues; Bittencourt, Paulo Fernando S; Ribeiro, Daniela F P; Silva, Rodrigo Gomes da; Alberti, Luiz Ronaldo

    2015-12-01

    The main goal of this paper is to investigate the frequency, clinical profile, and endoscopic findings of children and teenagers submitted to colonoscopies. Patients of below 18 years of age, diagnosed with polyps by means of colonoscopies at two reference centers of pediatric endoscopy were followed-up between 2002 and 2012. The clinical variables evaluated in this study included: gender, recommendation of colonoscopy, associated signs and symptoms, age of onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of intestinal polyposis and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, histology, and distribution. Polyposis syndromes were also investigated. From the 233 patients submitted to colonoscopies, polyps were found in 74 (31.7%) patients, with a median age of 6.6 years, of which 61% were male. Juvenile polyps were identified in 55 (74%) patients, with 7 (9%) characterized within the criteria for juvenile polyposis. Patients with intestinal polyposis syndromes were diagnosed in 35% of the patients. The most frequent clinical presentation was hematochezia. Abdominal pain with acute episodes of intestinal partial obstruction or intussusception with emergency laparotomy was observed in the majority of Peutz-Jeghers syndrome patients leading to an increased morbidity. Even though juvenile colonic polyps are the most frequent type of diagnosed polyps, the present study identified a significant level of children with polyposis syndromes (35%), associated with a higher morbidity of these individuals.

  4. Colorectal polyps in childhood.

    Science.gov (United States)

    Thakkar, Kalpesh; Fishman, Douglas S; Gilger, Mark A

    2012-10-01

    Colorectal polyps are a common cause of gastrointestinal bleeding in children. This review updates the information on colorectal polyps and summarizes the recent advances in genetics, diagnosis, and treatment of polyps in the large intestine. A review of recent literature regarding colorectal polyps demonstrates an estimated detected prevalence of 6.1% overall and 12.0% among those with lower gastrointestinal bleeding during pediatric colonoscopy. Non-Caucasian races (e.g., black and Hispanic) are at higher risk for colorectal polyps in childhood. Recent data show juvenile polyps may recur in approximately 45% of children with multiple polyps and 17% of children with solitary polyps. A clinical trial showed that celecoxib, a cyclooxygenase (COX)-2 inhibitor, significantly reduced the number of colorectal polyps in children with familial adenomatous polyposis (FAP). Ethical challenges related to genetic tests for FAP have been newly examined. The utility of novel endoscopic techniques (e.g., enteroscopy) in Peutz-Jeghers Syndrome to prevent intussusception have been newly described. Although colorectal polyps in children are generally benign and easily removed, careful clinical evaluation and ongoing research are needed to identify the small proportion of children at risk for cancer. The current paradigm of using the polyp number at presentation as a primary determinant of subsequent surveillance may be inadequate for many patients.

  5. Advances in point-of-care ultrasound in pediatric emergency medicine.

    Science.gov (United States)

    Gallagher, Rachel A; Levy, Jason A

    2014-06-01

    Point-of-care ultrasound (POCUS) has become an integral part of emergency medicine practice. Research evaluating POCUS in the care of pediatric patients has improved the understanding of its potential role in clinical care. Recent work has investigated the ability of pediatric emergency medicine (PEM) physicians to perform a wide array of diagnostic and procedural applications in POCUS ultrasound. Studies have demonstrated that PEM providers are able to identify an array of diseases, including intussusception, pyloric stenosis and appendicitis. Novel applications of ultrasound, such as a cardiac evaluation in the acutely ill patient or identification of skull fractures in the assessment of a patient with head injury, have shown excellent promise in recent studies. These novel applications have the potential to reshape pediatric diagnostic algorithms. Key applications in PEM have been investigated in the recent publications. Further exploration of the ability to integrate ultrasound into routine practice will require larger-scale studies and continued growth of education in the field. The use of ultrasound in clinical practice has the potential to improve safety and efficiency of care in the pediatric emergency department.

  6. Diagnostic imaging of digestive tract involvement in cystic fibrosis. Part 2: pancreatic and gastrointestinal disease

    International Nuclear Information System (INIS)

    Berrocal, T.; Prieto, C.; Miralles, M.; Pozo, G. del; Martinez, A.; Manzanares, J.

    1998-01-01

    Cystic fibrosis (CF) is the most common fatal, autosomal recessive disease among the white population. Although recurrent pulmonary infections and pulmonary insufficiency are the major causes of morbidity and mortality, gastrointestinal symptoms generally present earlier and may suggest the diagnosis in the newborn or even prior to birth. The changes are attributed to the secretion of an abnormally thick mucous into the intestinal lumen, leading to the hallmark of diseases of the digestive tract: obstruction. This can be detected at birth in the form of mecanium ileus, ileal atresia, mecanium peritonitis and mecomiun plug, or present later on in childhood and adolescence as distal bowel obstruction syndrome or fibrosing colonopathy. This thick mucous can also trigger intussusception or acute appendicitis. Pancreatic insufficiency or pancreatic enzyme replacement therapy is the direct cause of most of these disorders. Plain radiography is of the utmost utility in assessing the digestive tract in CF. When the disease is detected in a newborn, the recommended approach is to perform plain abdominal X-ray, followed by barium enema, always accompanied by ultrasound. In older children and adolescents, enema and ultrasound are usually sufficient, although computed tomography and magnetic resonance may sometimes be necessary. (Author) 52 refs

  7. Abdominal manifestations of cystic fibrosis in children

    International Nuclear Information System (INIS)

    Chaudry, Gulraiz; Navarro, Oscar M.; Levine, Daniel S.; Oudjhane, Kamaldine

    2006-01-01

    Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities. (orig.)

  8. Computed tomographic findings of abdominal complications of Crohn's disease - pictorial essay

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    Zissin, R. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel)]. E-mail: zisinrivka@clalit.org.il; Hertz, M. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv (Israel); Osadchy, A. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Novis, B. [Tel-Aviv Univ., Dept. of Gastroenterology, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Gayer, G. [Tel-Aviv Univ., Department of Diagnostic Imaging, Assaf Harode Medical Center, Zrifin, Sackler Faculty of Medicine, Tel Aviv (Israel)

    2005-02-15

    Crohn's disease (CD) is a chronic, transmural, inflammatory disease of the gastrointestinal tract (CIT) most often affecting the terminal ileum and colon. Diarrhea, abdominal pain, anorexia, nausea, and weight loss are the most common clinical symptoms. Abdominal complications of CD, both intestinal and extraintestinal, are frequent and variable. The most common intestinal complications include ileocolitis with external or internal fistulas and abscess formation, strictures, and bowel obstruction. Less common are free perforation, intussusception, and malignancy. The extraintestinal complications include nephrolithiasis, cholelithiasis, fatty liver, portal vein gas, and thromboembolic events. Nowadays, computed tomography (CT) provides superb anatomic detail and diagnostic accuracy of various intra-abdominal pathological processes, and it thus has become an essential diagnostic tool in the evaluation and management of patients wit known CD for the assessment of bowel wall involvement, the mesenteric extent of the disease, and inn-abdominal complications. In addition, as CT is frequently performed to evaluate patients with acute abdomen, it may encounter clinically unsuspected complications in patients with CD. This article reviews the CT features of various intra-abdominal complications of CD. (author)

  9. Diagnostic value of ultrasonography in evaluation and management of acute abdominal conditions in the paediatric age group

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    Mohd Khalid

    2012-01-01

    Full Text Available Background: The aims of this study have been elaborated below: (1 to enumerate the common causes of acute abdominal emergencies by ultrasonography in paediatric patients; (2 to establish the diagnostic efficacy of ultrasonography in evaluation of acute abdominal conditions in children and to illustrate the associated ultrasonographic findings; (3 and, to discuss the role of ultrasonography in guiding the mode of intervention in these cases. Patients and Methods: This prospective study of ultrasonographic examination in 146 paediatric patients presenting with acute onset abdominal pain at the emergency/paediatric outpatient department section of Jawaharlal Nehru Medical College & Hospital, Aligarh, between June 2006 and December 2007, using 3.75 MHz and 8 MHz transducers of the ADARA (Siemens machine. Results : Common causes of acute abdominal emergencies in pediatric patients as noted on ultrasonography included nonspecific pain (28%, abdominal abscess (21%, acute appendicitis (7% and intussusception (7%. Ultrasonography was diagnostic in 45.2% cases and supportive in 12.3% of the cases. As for as the final outcome, ultrasonography prevented surgery in almost 20% cases and laparotomy was avoided in 7% of the patients as ultrasound guided interventions in the form of abscess aspiration were carried out. Conclusion: Ultrasonography evaluation of children with acute abdominal pain, helps in making significant changes in the management plan of the patients, and also reveals various clinically unsuspected diseases.

  10. Complications of bariatric surgery: the acute care surgeon's experience.

    Science.gov (United States)

    Bradley, Joel F; Ross, Samuel W; Christmas, Ashley Britton; Fischer, Peter E; Sachdev, Gaurav; Heniford, Brant Todd; Sing, Ronald F

    2015-09-01

    Complications of bariatric surgeries are common, can occur throughout the patient's lifetime, and can be life-threatening. We examined bariatric surgical complications presenting to our acute care surgery service. Records were reviewed from January 2007 to June 2013 for patients presenting with a complication after bariatric surgery. Laparoscopic Roux-en-Y gastric bypass was the most common index operation (n = 20), followed by open Roux-en-Y gastric bypass (n = 6), laparoscopic gastric band (n = 4), and vertical banded gastroplasty (n = 3). Diagnoses included internal hernia (n = 10), small bowel obstruction (n = 5), lap band restriction (n = 4), biliary disease (n = 3), upper GI bleeding or ulcer (n = 3), ischemic bowel (n = 2), marginal ulcer (n = 2), gastric outlet obstruction (n = 2), perforated ulcer (n = 2), intussusception (n = 1), and incarcerated ventral hernia (n = 1). Operations were required in 91% of the patients. Laparoscopic outcomes were similar to open; however, open cases were more emergent (23.5% vs 69.2%) and had longer hospital length of stay (4.8 ± 3.5 vs 11.0 ± 10.3 days, P complications of bariatric surgery. Internal hernias or obstructive etiologies are the most common presentations and often require emergent or urgent surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. [Digestive surgical complications during pregnancy following bariatric surgery: Experience of a center for perinatology and obesity].

    Science.gov (United States)

    Chevrot, A; Lesage, N; Msika, S; Mandelbrot, L

    2016-04-01

    To describe severe complications during pregnancy requiring surgery in patients with a history of obesity surgery. A retrospective study in a hospital with tertiary care perinatology and an obesity reference center, on all pregnancies following bariatric surgery over a 10-year period, analyzing all cases of surgical complications. There were 8 major complications related to the procedure in 141 pregnancies with bariatric surgery. The 2 complications in women with gastric banding were band slippage resulting in severe dysphagia, one of which leading to intractable vomiting and serious hydrolectric disorders. Among the 6 complications after bypass surgery, 4 were occlusions: 3 on internal hernias of which 2 with volvulus and 1 associated with intestinal invagination, as well as one with intestinal invagination only. One patient had a laparotomy for a suspected invagination which was not confirmed. The other surgical complications after gastric bypass were a hernia and an exploratory laparotomy for suspected intussusception which was overturned. There was no case of maternal or perinatal death. Pregnancies in patients with a history of bariatric surgery are at high risk, in particular for complications related to the surgery and thus require careful interdisciplinary surveillance, and determination of predictive factors. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Effectiveness of the live attenuated rotavirus vaccine produced by a domestic manufacturer in China studied using a population-based case-control design.

    Science.gov (United States)

    Zhen, Shan-Shan; Li, Yue; Wang, Song-Mei; Zhang, Xin-Jiang; Hao, Zhi-Yong; Chen, Ying; Wang, Dan; Zhang, Yan-Hong; Zhang, Zhi-Yong; Ma, Jing-Chen; Zhou, Peng; Zhang, Zhen; Jiang, Zhi-Wei; Zhao, Yu-Liang; Wang, Xuan-Yi

    2015-10-01

    A universal rotavirus (RV) immunization program is a potentially cost-effective measure for preventing RV infection in China. However, the efficacy of the only licensed RV vaccine (Lanzhou lamb rotavirus vaccine, LLR), which is made by a domestic manufacturer, has not been proven by a properly designed clinical trial. In October 2011 to March 2012, to measure the potential protection provided by LLR, a case-control study nested in a population-based active diarrhea surveillance study of children control study comparing non-RV viral diarrheal cases with non-diarrheal controls in the same population found that the RV vaccine offered no protection against non-RV diarrhea. Even under a less ideal immunization schedule, the oral LLR conferred a certain level of protection against RV gastroenteritis. However, further studies are needed to understand the full characteristics of the LLR, including its efficacy when administered following the optimal regimen, the potential risk of inducing intussusception, and the direct and indirect protective effects of LLR.

  13. Surgical complications of hemolytic uremic syndrome: Single center experiences

    Directory of Open Access Journals (Sweden)

    Hooman Nakysa

    2007-01-01

    Full Text Available Purpose: To determine the prevalence, outcome and prognostic factors in children with hemolytic uremic syndrome (HUS who underwent laparotomy. Materials and Methods: The medical records of 104 patients with HUS who presented to our center between 1986 and 2003 were reviewed retrospectively. Data were analyzed using Student′s t test for comparing means, Fisher′s exact test for frequencies and Pearson′s correlation for finding the correlations. Results: 78% of cases presented with vomiting and diarrhea. Seven out of 104 needed surgical exploration. The indications of surgery were acute abdomen, severe abdominal distention and the sign of peritonitis. The findings at laparotomy were intussusceptions, perforation (colon, ileum, gangrene of entire colon, rectosigmoidal tearing, duodenal obstruction and toxic megacolon. Pathological findings were transmural infarction in two cases in which staged surgical management was performed (cecostomy, resection, later anastomosis. Four out of seven patients died because of pulmonary failure, coma and multiple organ failure ( P< 0.05 compared to those who did not need laparotomy. The patients requiring surgery were young (< 3 years, had high leukocyte count (>20000 mm 3 and low albumin level (< 3g/dl ( P< 0.05. Conclusion: Surgical complications of HUS are rare but are assorted with high mortality due to respiratory failure and multiple organ failure. Early decision of laparotomy associated with intensive care, including mechanical ventilation, adequate dialysis and ultrafiltration, are recommended.

  14. Computed tomography of complicated Meckel's diverticulum in adults: a pictorial review.

    Science.gov (United States)

    Platon, Alexandra; Gervaz, Pascal; Becker, Christoph D; Morel, Philippe; Poletti, Pierre-Alexandre

    2010-05-01

    OBJECTIVE: To show various CT aspects of complicated Meckel's diverticulum in adult patients to facilitate the preoperative diagnosis of this rare pathology in emergency settings. METHODS: A computer search of medical records over a 15 year period identified 23 adult patients who underwent surgery for acute abdomen generated by a complicated Meckel's diverticulum. CT images available for review were analyzed, and some specific patterns leading to the diagnosis of complicated Meckel's diverticulum are presented in this review. RESULTS: Complications were related to inflammation (14 patients), bleeding (5 patients), intestinal obstruction (3 patients), and penetrating foreign body (1 patient). The presence of a Meckel's diverticulum was usually suggested at CT scan by an abnormal outpouching, blind-ending digestive structure connected to the terminal ileum by a neck of variable caliber. Depending on the type of complications, the diverticulum was surrounded by mesenteric inflammatory changes, or presented as a localized fluid or air-fluid collection contiguous with the terminal ileum. The diverticulum was also the source of active bleeding or acted as the lead point to intestinal obstruction or intussusception. CONCLUSION: CT findings of complicated Meckel's diverticulum are polymorphic and should be considered in the evaluation of adult patients with acute abdomen.

  15. Corticosteroid therapy in Henoch-Schönlein gastritis

    Directory of Open Access Journals (Sweden)

    Pavlović Momčilo

    2007-01-01

    Full Text Available Introduction. Henoch-Schönlein purpura (HSP is the most common vascular disease of childhood. It is a multisystem disease most commonly affecting the skin, joints, gastrointestinal tract, and kidneys, but other organs may be affected, too. Gastrointestinal involvement occurs in approximately 65-90% of patients, ranging from mild symptoms such as abdominal pain, nausea, and vomiting, to more severe manifestations such as gastrointestinal bleeding and intussusception. In most cases, HSP spontaneously resolves without treatment. The use of corticosteroids is controversial and usually reserved for severe systemic manifestations. Some authors suggest that the abdominal pain and gastrointestinal hemorrhage of HSP may respond to steroids, with some suggesting that there is a benefit in their use and describing a regimen. Case outline. This is a case report of HSP in a fourteen year-old boy with abdominal pain and hematemesis. Upper endoscopy showed an edematous and erythematous change in the body of the stomach and purpuric lesions in the duodenum, while multiple erosions were found in the antral area. Parenteral corticosteroid therapy with gastric acid secretion inhibitor administration led to regression of gastrointestinal symptoms on the seventh day, with relapses on the fourth and sixth day. Peroral administration of corticosteroids and gradual decrease of daily doses started on the eighth day of abdominal symptoms. New purpuric skin rashes appeared during six weeks. Conclusion. Corticosteroid therapy with gastric acid secretion inhibitors showed a positive effect in our patient with a severe form of HSP accompanied by abdominal pain and gastrointestinal hemorrhage. .

  16. Lumbar Swelling as the Unusual Presentation of Henoch-Schonlein Purpura in a Child

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    Mehmet Ali Duman

    2016-06-01

    Full Text Available Background: Henoch-Schönlein Purpura (HSP is a systemic hypersensitivity disease of unknown cause that is characterized by a purpuric rash and systemic manifestations, such as colicky abdominal pain, polyarthralgia, and acute glomerulonephritis. Common complications of HSP that lead to surgical intervention include intussusception, perforation, necrosis, and massive gastrointestinal bleeding. Unusual clinical manifestations of HSP may include edema of the scrotum and eyes. Lumbar swelling is rarely seen as a complication of HSP. Case Report: A four-year-old boy was admitted to our emergency room with a 7 day history of increasing abdominal pain. Within 48 hours of admission, erythematous macules and palpable purpuric lesions developed on the lower extremities. On the third day of hospitalization, sudden onset of severe back pain, swelling on the lumbar region and refusal to walk were seen. On the fifth day, lumbosacral edema and pain resolved but facial edema developed. He was diagnosed clinically with HSP. Conclusion: To the best of our knowledge, only a few cases of HSP with lumbar edema have been reported so far. If the first clinical symptoms of HSP are atypical, clinical progress can be atypical, too.

  17. Skin Vaccination against Rotavirus Using Microneedles: Proof of Concept in Gnotobiotic Piglets.

    Directory of Open Access Journals (Sweden)

    Yuhuan Wang

    Full Text Available Live-attenuated oral rotavirus (RV vaccines have lower efficacy in low income countries, and additionally are associated with a rare but severe adverse event, intussusception. We have been pursuing the development of an inactivated rotavirus vaccine (IRV using the human rotavirus strain CDC-9 (G1P[8] through parenteral immunization and previously demonstrated dose sparing and enhanced immunogenicity of intradermal (ID unadjuvanted IRV using a coated microneedle patch in comparison with intramuscular (IM administration in mice. The aim of this study was to evaluate the immune response and protection against RV infection and diarrhea conferred by the administration of the ID unadjuvanted IRV using the microneedle device MicronJet600® in neonatal gnotobiotic (Gn piglets challenged with virulent Wa G1P[8] human RV. Three doses of 5 μg IRV when administered intradermally and 5 μg IRV formulated with aluminum hydroxide [Al(OH3] when administered intramuscularly induced comparable rotavirus-specific antibody titers of IgA, IgG, IgG avidity index and neutralizing activity in sera of neonatal piglets. Both IRV vaccination regimens protected against RV antigen shedding in stools, and reduced the cumulative diarrhea scores in the piglets. This study demonstrated that the ID and IM administrations of IRV are immunogenic and protective against RV-induced diarrhea in neonatal piglets. Our findings highlight the potential value of an adjuvant sparing effect of the IRV ID delivery route.

  18. Retrospective evaluation of recurrent secondary septic peritonitis in dogs (2000-2011): 41 cases.

    Science.gov (United States)

    Barfield, Dominic M; Tivers, Michael S; Holahan, Matthew; Welch, Kristin; House, Arthur; Adamantos, Sophie E

    2016-01-01

    To describe the clinical characteristics of recurrent septic peritonitis in dogs. Multicenter retrospective observational study. Client-owned dogs with recurrent septic peritonitis. Three university emergency and referral hospitals. None. Medical records from 3 veterinary university teaching hospitals were reviewed and data were collected using a standardized data collection sheet for all cases of septic peritonitis during the study period (2000-2011). Forty one dogs met the inclusion criteria for recurrent peritonitis. All dogs underwent relaparotomy. The original cause of septic peritonitis in these cases included previous surgery for gastrointestinal foreign body removal (n = 26), gastrointestinal neoplasia (n = 3), gastric or duodenal ulceration (n = 3), biliary tract leakage (n = 2), and single instance for each of the following: penetrating foreign body, hernia strangulation, intussusception, mesenteric volvulus, infection of the laparotomy incision, prostatic abscess, and trauma. Eighteen animals survived to discharge. There was no difference detected between survivors and nonsurvivors with recurrent peritonitis in terms of inciting cause, serum albumin concentration, surgical management, or provision of appropriate initial antimicrobials. The survival rate for dogs having recurrent peritonitis was 43.9% (18/41 dogs). This retrospective study did not identify any significant prognostic indicators for dogs with recurrent peritonitis and that the mortality rate for dogs having more than one surgery for septic peritonitis is similar to that reported for a single surgery for septic peritonitis. ©Veterinary Emergency and Critical Care Society 2015.

  19. [Specificities in children wound healing].

    Science.gov (United States)

    Sanchez, J; Antonicelli, F; Tuton, D; Mazouz Dorval, S; François, C

    2016-10-01

    Children have specific characteristics of wound healing. The aim of this study was to describe the specific clinical characteristics of wounds healing in children and to present the current knowledge on the specific mechanisms with regard to infant age. The tissue insult or injury in fetus can heal without scar, mainly due to reduced granulation tissue associated to diminished or even no inflammatory phase, modified extracellular matrix such as the concentration of hyaluronic acid in amniotic liquid, expression and arrangement of collagen and tenascin. Thickness of children skin is a serious negative factor in case of trauma, whereas poor co-morbidities and efficient growth tissue mechanisms are beneficial to good evolution, even in cases of extensive damage and loss of tissue. The subsequent tissue mechanical forces, wound healing during childhood, spanning from the age of 2 until the end of puberty, is associated with more hypertrophic scars, both in duration and in intensity. Consequently, unnecessary surgery has to be avoided during this period when possible, and children with abnormal or pathologic wound healing should benefit from complementary treatments (hydration, massage, brace, silicone, hydrotherapy…), which represent efficient factors to minimize tissue scarring. After wound healing, the growth body rate can be responsible for specific complications, such as contractures, alopecia, and scar intussusceptions. Its evolutionary character implies the need of an attentive follow-up until adult age. Psychologic repercussions, as a consequence of pathologic scars, must be prevented and investigated by the surgeon. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. The postoperative stomach

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    Woodfield, Courtney A. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States); Levine, Marc S. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States)]. E-mail: marc.levine@uphs.upenn.edu

    2005-03-01

    Gastric surgery may be performed for the treatment of a variety of benign and malignant diseases of the upper gastrointestinal tract, including peptic ulcers and gastric carcinoma. Radiographic studies with water-soluble contrast agents often are obtained to rule out leaks, obstruction, or other acute complications during the early postoperative period. Barium studies may also be obtained to evaluate for anastomotic strictures or ulcers, bile reflux gastritis, recurrent tumor, or other chronic complications during the late postoperative period. Cross-sectional imaging studies such as CT are also helpful for detecting abscesses or other postoperative collections, recurrent or metastatic tumor, or less common complications such as afferent loop syndrome or gastrojejunal intussusception. It is important for radiologists to be familiar not only with the radiographic findings associated with these various abnormalities but also with the normal appearances of the postoperative stomach on radiographic examinations, so that such appearances are not mistaken for pseudoleaks or other postoperative complications. The purpose of this article is to describe the normal postsurgical anatomy after the most commonly performed operations (including partial gastrectomy, esophagogastrectomy and gastric pull-through, and total gastrectomy and esophagojejunostomy) and to review the acute and chronic complications, normal postoperative findings, and major abnormalities detected on radiographic examinations in these patients.

  1. The Effectiveness of Ultrasonography in Detecting Emergent Pediatric Pathologies and Requirement for Additional Imaging Techniques: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Betül Tiryaki Baştuğ

    2018-04-01

    Full Text Available Introduction: In emergency cases, ultrasonography is used in guiding resuscitation, to provide procedural guidance, and confirm a clinical diagnosis. In addition, it may prevent unnecessary exposure of the patient to ionizing radiation and risks caused by transporting the patient away from monitoring. This paper aimed to evaluate the effectiveness of ultrasonography in detecting emergent pediatric pathologies in a state hospital radiology unit, and to identify whether additional imaging techniques, such as computed tomography, were required. Methods: This study was designed as a retrospective investigation. A group of 536 patients were randomly selected from 1.401 pediatric patients who underwent ultrasonography for non-traumatic emergent pathologies between 2015 and 2016. Results: Of the 536 patients, 46 were diagnosed with appendicitis, 14 with pathologies of the urinary system, 1 with ileus, 29 with mesenteric lymphadenitis, 4 with intussusception, 3 with ovarian cyst rupture, 1 with ovarian torsion, and 32 with scrotal pathologies. Computed tomography was performed for 20 patients. Ureteral calculi and appendicitis were confirmed by computed tomography in 5 and 14 patients, respectively, after being identified as secondary findings by ultrasonography. In 1 patient, ileus was verified by computed tomography. The sensitivity of ultrasonography was determined to be 85.7%. Only 14% of patients were not given definite pathological diagnoses by ultrasonography alone. Subsequent computed tomography for verifying secondary findings detected by ultrasonography was essential in only 20 patients. Conclusion: Our results promote the use of ultrasonography as the initial imaging test for evaluating pediatric patients with suspected emergency pathologies.

  2. The value of dynamic magnetic resonance imaging in interdisciplinary treatment of pelvic floor dysfunction.

    Science.gov (United States)

    Attenberger, U I; Morelli, J N; Budjan, J; Herold, A; Kienle, P; Kleine, W; Häcker, A; Baumann, C; Heinzelbecker, J; Schoenberg, S O; Michaely, H J

    2015-10-01

    The purpose of this study was to determine the value of dynamic pelvic floor MRI relative to standard clinical examinations in treatment decisions made by an interdisciplinary team of specialists in a center for pelvic floor dysfunction. 60 women were referred for dynamic pelvic floor MRI by an interdisciplinary team of specialists of a pelvic floor center. All patients were clinically examined by an urologist, gynecologist, a proctological, and colorectal surgeon. The specialists assessed individually and in consensus, whether (1) MRI provides important additional information not evident by physical examination and in consensus whether (2) MRI influenced the treatment strategy and/or (3) changed management or the surgical procedure. MRI was rated essential to the treatment decision in 22/50 cases, leading to a treatment change in 13 cases. In 12 cases, an enterocele was diagnosed by MRI but was not detected on physical exam. In 4 cases an enterocele and in 2 cases a rectocele were suspected clinically but not confirmed by MRI. In 4 cases, MRI proved critical in assessment of rectocele size. Vaginal intussusception detected on MRI was likewise missed by gynecologic exam in 1 case. MRI allows diagnosis of clinically occult enteroceles, by comprehensively evaluating the interaction between the pelvic floor and viscera. In nearly half of cases, MRI changed management or the surgical approach relative to the clinical evaluation of an interdisciplinary team. Thus, dynamic pelvic floor MRI represents an essential component of the evaluation for pelvic floor disorders.

  3. The value of additional videorecordings on defecography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sung Ki; Choi, Sang Hee; Kim, Seung Hoon; Kim, Seung Kwon; Lim, Hyo Keun; Lee, Soon Jin; Kim, Bo Hyun [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-12-01

    To determine the value of additional videorecording during defecography. Ninety-nine consecutive patients (20 males, 79 females;mean age:48 yrs) who between august 1996 and June 1997 had undergone defecography due to defecation difficulty were included in this study. In all patients, spot filming(at rest, during squeezing, during straining) and videorecording during defecography were simultaneously performed. Two radiologists retrospectively reviewed spot films and video images, analyzed discrepancies between the two methods, and reached a consensus. In 52% of patients (51/99), the results of the two examinations were discrepant. The most common finding was anterior rectocele (n=3D33), followed by spastic pelvic floor syndrome (n=3D16), rectal intussusception (n=3D5), posterior rectocele (n=3D3), mucosal prolapse (n=3D2), descending perineal syndrome (n=3D2), and rectal prolapse (n=3D1). All findings except spastic pelvic floor syndrome were additionally found on videorecording. Because videorecording during defecography showed additional findings in 52% of patients, it is a necessary procedure for the diagnosis and management of patients with defecation difficulty.=20.

  4. Total pelvic floor ultrasound for pelvic floor defaecatory dysfunction: a pictorial review

    Science.gov (United States)

    Solanki, Deepa; Schizas, Alexis M P; Williams, Andrew B

    2015-01-01

    Total pelvic floor ultrasound is used for the dynamic assessment of pelvic floor dysfunction and allows multicompartmental anatomical and functional assessment. Pelvic floor dysfunction includes defaecatory, urinary and sexual dysfunction, pelvic organ prolapse and pain. It is common, increasingly recognized and associated with increasing age and multiparity. Other options for assessment include defaecation proctography and defaecation MRI. Total pelvic floor ultrasound is a cheap, safe, imaging tool, which may be performed as a first-line investigation in outpatients. It allows dynamic assessment of the entire pelvic floor, essential for treatment planning for females who often have multiple diagnoses where treatment should address all aspects of dysfunction to yield optimal results. Transvaginal scanning using a rotating single crystal probe provides sagittal views of bladder neck support anteriorly. Posterior transvaginal ultrasound may reveal rectocoele, enterocoele or intussusception whilst bearing down. The vaginal probe is also used to acquire a 360° cross-sectional image to allow anatomical visualization of the pelvic floor and provides information regarding levator plate integrity and pelvic organ alignment. Dynamic transperineal ultrasound using a conventional curved array probe provides a global view of the anterior, middle and posterior compartments and may show cystocoele, enterocoele, sigmoidocoele or rectocoele. This pictorial review provides an atlas of normal and pathological images required for global pelvic floor assessment in females presenting with defaecatory dysfunction. Total pelvic floor ultrasound may be used with complementary endoanal ultrasound to assess the sphincter complex, but this is beyond the scope of this review. PMID:26388109

  5. The imaging of coeliac disease and its complications

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    Buckley, O.; Brien, J.O.; Ward, E.; Doody, O.; Govender, P. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin (Ireland); Torreggiani, W.C. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin (Ireland)], E-mail: William.torreggiani@amnch.ie

    2008-03-15

    Coeliac disease is a malabsorption syndrome in which dietary gluten damages the small bowel mucosa. Gluten contains gliadin, the primary toxic component that is primarily found in wheat, barley and rye products. The initial diagnosis of coeliac disease is usually made by endoscopic biopsy of the jejunum although sometimes imaging features can suggest the diagnosis. Once a diagnosis is made, patients need to be diet compliant and monitored for potential complications. Many complications are more common when dietary compliance is poor. Complications include intussusception (usually intermittent), ulcerative jejunitis, osteomalacia, cavitating lymph node syndrome and an increased risk of malignancies such as lymphoma, adenocarcinoma and squamous cell carcinoma. Radiological evaluation is central in the evaluation of these complications. Imaging may assist both in the diagnosis and staging of complications as well as enabling radiological guided percutaneous biopsy for complications of coeliac disease such as lymphoma. As coeliac disease is a relatively common disorder, it is likely that most radiologists will encounter the disease and its potential complications. The aim of this review article is to discuss and illustrate the role of modern radiology in evaluating the many presentations of this complex disease.

  6. Computed tomographic findings of abdominal complications of Crohn's disease - pictorial essay

    International Nuclear Information System (INIS)

    Zissin, R.; Hertz, M.; Osadchy, A.; Novis, B.; Gayer, G.

    2005-01-01

    Crohn's disease (CD) is a chronic, transmural, inflammatory disease of the gastrointestinal tract (CIT) most often affecting the terminal ileum and colon. Diarrhea, abdominal pain, anorexia, nausea, and weight loss are the most common clinical symptoms. Abdominal complications of CD, both intestinal and extraintestinal, are frequent and variable. The most common intestinal complications include ileocolitis with external or internal fistulas and abscess formation, strictures, and bowel obstruction. Less common are free perforation, intussusception, and malignancy. The extraintestinal complications include nephrolithiasis, cholelithiasis, fatty liver, portal vein gas, and thromboembolic events. Nowadays, computed tomography (CT) provides superb anatomic detail and diagnostic accuracy of various intra-abdominal pathological processes, and it thus has become an essential diagnostic tool in the evaluation and management of patients wit known CD for the assessment of bowel wall involvement, the mesenteric extent of the disease, and inn-abdominal complications. In addition, as CT is frequently performed to evaluate patients with acute abdomen, it may encounter clinically unsuspected complications in patients with CD. This article reviews the CT features of various intra-abdominal complications of CD. (author)

  7. Distal ureterectomy techniques in laparoscopic and robot-assisted nephroureterectomy: Updated review

    Directory of Open Access Journals (Sweden)

    Konstantinos G Stravodimos

    2015-01-01

    Full Text Available Controversies exist about the best method for managing the distal ureter during the laparoscopic (LNU and robot-assisted nephroureterectomy (RANU. Therefore, PubMed, Scopus and Web of Science databases were searched in order to identify articles describing the management of distal ureter during LNU or RANU in patients suffering from upper urinary tract urothelial cell carcinoma. Forty seven articles were selected for their relevance to the subject of this review. The approaches that are usually performed regarding the distal ureter management are open excision, transurethral resection of ureteral orifice (Pluck Technique, ureteric intussusception and pure LNU or pure RANU. Pure LNU and RANU with complete laparoscopic dissection and suture reconstruction of ureter and bladder cuff seems to be better tolerated than open nephroureterectomy providing equal efficacy, without deteriorating the oncological outcome, however evidence is poor. Transurethral resection of the ureteric orifice and the bladder cuff after occlusion of the ureter with a balloon catheter seems to be an attractive alternative option for low stage, low grade tumors of the renal pelvis and the proximal ureter, while stapling technique is correlated with the increased risk of positive surgical margins. The open resection of the distal ureter in continuity with the bladder cuff is considered the most reliable approach, preferred in our practice as well, however the existing data are based on retrospective and non-randomized studies.

  8. Complications of nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Se Jin Park

    2011-08-01

    Full Text Available Nephrotic syndrome (NS is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox, thromboembolism (e.g., venous thromboembolism and pulmonary embolism, hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension, cardiovascular problems (e.g., hyperlipidemia, acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception. The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

  9. Experience with imaging methods in the diagnosis and therapy of invagination in pediatric patients

    International Nuclear Information System (INIS)

    Gagov, E.; Garvanska, G.; Totev, M.; Panov, M.

    2002-01-01

    Intussusception is the commonest cause of acquired intestinal obstruction in children. In 60 to 78 % of the cases children up to 2 years of age are involved, and in 10 per cent - children older than 3 years. Etiologically relevant are both mechanical factors, such as Meckel's diverticulum, tumor, polyps, intramural intestinal hematoma, hyperplasia of lymph nodes, foreign bodies and the like, as well as impairment of the intestinal tract innervation, with the combination secondary hyperplastic intestinal lymph nodes plus intestinal hyper peristalsis against the background of infection of the upper airways taken to be the commonest underlying cause. Single and multi-cylinder invagination are likewise differentiated with the frequency of their occurrence in the different intestinal tract sections being likewise variable.The study covers 93 children aged up to 11 years, undergoing treatment in the pediatric Abdominal Surgery Department with the Emergency Institute Pirogov over a 3-year period (1998 - 2000). In all children radiological studies are performed including chest radiography, serial X-rays for acute abdomen in prone and supine position, ultrasound examination of the abdomen, and air-contrast pneumocoloscopy. (authors)

  10. Abdominal manifestations of cystic fibrosis in children

    Energy Technology Data Exchange (ETDEWEB)

    Chaudry, Gulraiz; Navarro, Oscar M.; Levine, Daniel S.; Oudjhane, Kamaldine [University of Toronto, Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada)

    2006-03-15

    Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities. (orig.)

  11. Chronic intestinal pseudo-obstruction in adult patients: multidetector row helical CT features

    Energy Technology Data Exchange (ETDEWEB)

    Merlin, Aurelie; Soyer, Philippe; Boudiaf, Mourad; Hamzi, Lounis; Rymer, Roland [University Paris 7 (France). Department of Abdominal Imaging; GHU Nord, Paris (France)

    2008-08-15

    Chronic intestinal pseudo-obstruction (CIPO) is a rare condition due to severe gastrointestinal motility disorder. Adult patients with CIPO experience symptoms of mechanical obstruction, but reliable clinical signs that may help distinguish between actual mechanical obstruction and CIPO are lacking. Additionally, abdominal plain films that commonly show bowel dilatation with air-fluid levels do not reach acceptable degrees of specificity to exclude actual obstruction. Therefore, most adult patients with CIPO usually undergo multiple and often fruitless surgery, often leading to repeated bowel resections before diagnosis is made. In these patients who present with abdominal signs mimicking symptoms that would warrant surgical exploration, multidetector-row helical CT (MDCT) is helpful to resolve this diagnostic dilemma. MDCT shows a diffusely distended bowel and helps to rule out a mechanical cause of obstruction, thus suggesting CIPO and obviating the need for unnecessary laparotomy. In adult patients with CIPO, MDCT may show pneumatosis intestinalis, pneumoperitoneum or intussusception. However, these conditions generally do not require surgery in patients with CIPO. This pictorial essay presents the more and less common MDCT features of CIPO in adult patients, to make the reader more familiar with this disease. (orig.)

  12. Pre-hatch lung development in the ostrich.

    Science.gov (United States)

    Makanya, A N; Koller, T; Hlushchuk, R; Djonov, V

    2012-03-15

    We studied development of the ostrich lung using light microscopy as well as electron microscopy techniques. At E24, the lung comprised a few epithelial tubes, interspersed with abundant mesenchyme with scattered profiles of incipient blood vessels. Between E24 and E39, the epithelial thickness was reduced by 90% from 13.5 ± 0.41 μm to 1.33 ± 0.014 μm (mean ± SD, respectively). Atria were evident at E32, and by E35, the first portions of the blood-gas barrier (BGB) measuring 3.41 ± 1.12 μm were encountered. Gas exchange tissue was well formed by E39 with atria, infundibulae, air capillaries and a mature blood-gas barrier (BGB). BGB formation proceeded through the complex processes of secarecytosis and peremerecytosis, which entailed decapitation of epithelial cells by cutting or pinching off respectively and by E39, the BGB was thin at 2.21 ± 1.21 μm. Vascular remodeling by intussusceptive angiogenesis was a late stage process mediated by intraluminal pillars in the pulmonary vasculature. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Laparoscopy and complicated meckel diverticulum in children.

    Science.gov (United States)

    Alemayehu, Hanna; Stringel, Gustavo; Lo, Irene J; Golden, Jamie; Pandya, Samir; McBride, Whitney; Muensterer, Oliver

    2014-01-01

    Meckel diverticulum can present with a variety of complications but is often found incidentally during other surgical procedures. The role of laparoscopy in the management of Meckel diverticulum is established. We reviewed our experience with complicated cases of Meckel diverticulum in children managed with laparoscopy. A 15-year retrospective chart review revealed 14 cases of complicated Meckel diverticulum managed with laparoscopy. Incidentally found Meckel diverticulum and cases done by laparotomy were excluded. Ages varied from 2 years to 16 years old. There were 10 males and four females. Eight cases had small bowel obstruction; of those, three had extensive intestinal gangrene. Four cases had significant rectal bleeding, three had acute diverticulitis, and two had intussusception caused by the diverticulum. Eleven cases were treated with laparoscopic Meckel diverticulectomy and three with laparoscopic-assisted bowel resection because of extensive gangrene of the intestine. Two of the three cases with significant intestinal gangrene returned several weeks later with small bowel obstruction secondary to adhesions. They were successfully managed with laparoscopic lysis of adhesions. There were no other complications. Laparoscopy is safe and effective in the management of complicated Meckel diverticulum in children. Most cases can be managed with simple diverticulectomy. Laparoscopy is useful when the diagnosis is uncertain. When extensive gangrene is present, laparoscopy can help to mobilize the intestine and evaluate the degree of damage, irrigate and cleanse the peritoneal cavity, and minimize the incision necessary to accomplish the bowel resection.

  14. Ileocolic junction resection in dogs and cats: 18 cases.

    Science.gov (United States)

    Fernandez, Yordan; Seth, Mayank; Murgia, Daniela; Puig, Jordi

    2017-12-01

    There is limited veterinary literature about dogs or cats with ileocolic junction resection and its long-term follow-up. To evaluate the long-term outcome in a cohort of dogs and cats that underwent resection of the ileocolic junction without extensive (≥50%) small or large bowel resection. Medical records of dogs and cats that had the ileocolic junction resected were reviewed. Follow-up information was obtained either by telephone interview or e-mail correspondence with the referring veterinary surgeons. Nine dogs and nine cats were included. The most common cause of ileocolic junction resection was intussusception in dogs (5/9) and neoplasia in cats (6/9). Two dogs with ileocolic junction lymphoma died postoperatively. Only 2 of 15 animals, for which long-term follow-up information was available, had soft stools. However, three dogs with suspected chronic enteropathy required long-term treatment with hypoallergenic diets alone or in combination with medical treatment to avoid the development of diarrhoea. Four of 6 cats with ileocolic junction neoplasia were euthanised as a consequence of progressive disease. Dogs and cats undergoing ileocolic junction resection and surviving the perioperative period may have a good long-term outcome with mild or absent clinical signs but long-term medical management may be required.

  15. Vaccine Adverse Events: Separating Myth from Reality.

    Science.gov (United States)

    Spencer, Jeanne P; Trondsen Pawlowski, Ruth H; Thomas, Stephanie

    2017-06-15

    Vaccines are one of the most successful medical advances in modern times. Most vaccine-preventable illnesses are unfamiliar to modern parents. Because of this, parents are increasingly questioning the necessity of immunizing their children, especially because no vaccine is completely free of adverse effects or the risk of complications. Family physicians should be aware of the risks and benefits of recommended immunizations. Thimerosal is currently used only in multidose vials of influenza vaccine, and exposure through vaccines is not associated with adverse neurologic outcomes. The measles, mumps, and rubella vaccine is not associated with autism. Vaccines are associated with local reactions, such as pain and erythema. The rotavirus vaccine minimally increases the rate of intussusception, whereas other vaccines minimally increase the risk of syncope. Although immunization with the human papillomavirus vaccine is recommended for all boys and girls, vaccination rates remain low. Physicians should guide parents to credible resources if they are considering vaccine refusal. If a recommended vaccine is refused, proper documentation is essential. The Vaccine Adverse Event Reporting System and National Vaccine Injury Compensation Program track adverse events and allow compensation for documented harms from vaccinations.

  16. Early complications after stapled transanal rectal resection performed using the Contour® Transtar™ device.

    Science.gov (United States)

    Martellucci, J; Talento, P; Carriero, A

    2011-12-01

    This study evaluated the early results (with particular reference to complications) of stapled transanal rectal resection (STARR) carried out using the CCS-30 Contour® Transtar™ device. The procedure was performed in a single centre on patients with obstucted defecation caused by rectocele or rectal intussusception. From July 2007 to February 2009, 133 patients were treated. Preoperatively, all underwent clinical examination, transanal ultrasonography, anorectal manometry and cinedefaecography. Obstructed defaecation syndrome was assessed using the Cleveland Clinic Constipation Score (CCC-S). Early postoperative complications and those occurring within 6 months were recorded. The median follow-up period was 19 (range 12-30) months. The mean ± standard deviation preoperative CCC-S of 19.4 ± 7.1 decreased to 10.1 ± 9.0 postoperatively. The early complication rate was 15.7% and included rectovaginal fistula (n = 1), rectal perforation (n = 1), posterior dehiscence (n = 4), further surgery for retained staples (n = 2), postoperative bleeding (n = 2) and postoperative impaired continence (n = 11). STARR using the Contour Transtar device seems to be effective for treating obstructed defaecation. However, serious complications may occur. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  17. [Non-Hodgkin's primary intestinal lymphoma - a cause of acute abdominal manifestation in children].

    Science.gov (United States)

    Brankov, O; Dumanov, K; Stoilov, S; Doĭnova, P; Drebov, R; Khristozova, I

    2007-01-01

    Lymphomas of the gastrointestinal tract are the most common type of primary extranodal lymphomas, accounting for 5 to 10% of all non-Hodgkin's lymphomas (NHL). From January 1996 to November 2005, 10 patients with primary intestinal lymphomas were submitted with clinical signs of acute abdomen to the Pediatric surgical department in Sofia. The children presented with radiologically proven intussusception, ileal obstruction or peritonitis due to bowel perforation. At exploration the tumor was located in the ileum in 4 cases, in the terminal ileum and coecum in 3 cases, appendix in one and multiple sites were found in 2 cases. Children with localized disease underwent radical resection of the tumor mass with ileo - transverso anastomosis (3), partial bowel resection (4), and appendectomy (1) whereas in 2 children with advanced disease diagnostic biopsy alone with temporary ileostomy in one were accomplished. According to histology, 5 patients had Burkitt lymphoma and 5 lymphoblast NHL. The children were treated according CHOP. Over five - years relapse - free survival for localized disease accounts 6 children. Primary NHL in children often presents with acute abdominal condition requiring surgical exploration. Prognosis depends of adequacy of surgical resection and the adjuvant chemotherapy.

  18. An uncommon case of late-onset congenital diaphragmatic hernia with bloody stool

    Directory of Open Access Journals (Sweden)

    Keisuke Jimbo

    2016-10-01

    Full Text Available Late-onset congenital diaphragmatic hernia (CDH is an uncommon subset of CDH and distinct from neonatal CDH with respect to presenting symptoms, diagnosis, management, and prognosis. In particular, CDH diagnosed after 30 days of age (late-onset CDH is uncommon and has an atypical presentation and a more favorable prognosis. In the present report, an infantile late-onset CDH case that presented with bloody stool and had a severe clinical course is described. In previous reports, no late-onset CDH case developed bloody stool. After diagnosis with image inspections, emergency surgery was performed. At operation, via the hernia orifice, the jejunum was seen to have prolapsed into the thoracic cavity with focally significant intestinal and mesenteric congestion, but no intestinal necrosis. In general, other disorders such as intussusception may be considered in the differential diagnosis of acute abdomen with bloody stool in patients of this age. However, in such late-onset CDH cases, immediate differentiation from other causes of acute abdomen that present with bloody stool is life-saving.

  19. Rectal hyposensitivity and functional anorectal outlet obstruction are common entities in patients with functional constipation but are not significantly associated.

    Science.gov (United States)

    Lee, Tae Hee; Lee, Joon Seong; Hong, Su Jin; Jeon, Seong Ran; Kwon, Soon Ha; Kim, Wan Jung; Kim, Hyun Gun; Cho, Won Young; Cho, Joo Young; Kim, Jin-Oh; Lee, Ji Sung

    2013-01-01

    The causes of functional anorectal outlet obstruction (outlet obstruction) include functional defecation disorder (FDD), rectocele, and rectal intussusception (RI). It is unclear whether outlet obstruction is associated with rectal hyposensitivity (RH) in patients with functional constipation (FC). The aim of this study was to determine the association between RH and outlet obstruction in patients with FC. This was a retrospective study using a prospectively collected constipation database, and the population comprised 107 patients with FC (100 females; median age, 49 years). We performed anorectal manometry, defecography, rectal barostat, and at least two tests (balloon expulsion test, electromyography, or colon transit time study). RH was defined as one or more sensory threshold pressures raised beyond the normal range on rectal barostat. We investigated the association between the presence of RH and an outlet obstruction such as large rectocele (> 2 cm in size), RI, or FDD. Forty patients (37.4%) had RH. No significant difference was observed in RH between patients with small and large rectoceles (22 [44.9%] vs. 18 [31%], respectively; p = 0.140). No significant difference was observed in RH between the non-RI and RI groups (36 [36.7%] vs. 4 [30.8%], respectively; p = 0.599). Furthermore, no significant difference in RH was observed between the non-FDD and FDD groups (19 [35.8%] vs. 21 [38.9%], respectively; p = 0.745). RH and outlet obstruction are common entities but appear not to be significantly associated.

  20. Gastrointestinal involvement of recurrent renal cell carcinoma: CT findings and clinicpathologic features

    International Nuclear Information System (INIS)

    Park, Hyo Jung; Kim, Hyun Jin; Park, Seung Ho; Lee, Jong Seok; Kim, Ah Young; Ha, Hyun Kwon

    2017-01-01

    To retrospectively evaluate the CT findings and clinicopathologic features in patients with gastrointestinal (GI) involvement of recurrent renal cell carcinoma (RCC). The medical records were reviewed for 15 patients with 19 pathologically proven GI tract metastases of RCC. The CT findings were analyzed to determine the involved sites and type of involvement; lesion size, morphology, and contrast enhancement pattern; and occurrence of lymphadenopathy, ascites and other complications. The most common presentation was GI bleeding (66.7%). The average interval between nephrectomy and the detection of GI involvement was 30.4 ± 37.4 months. GI lesions were most commonly found in the ileum (36.8%) and duodenum (31.6%). A distant metastasis (80%) was more common than a direct invasion from metastatic lesions. The mean lesion size was 34.1 ± 15.0 mm. Intraluminal polypoid masses (63.2%) with hyperenhancement (78.9%) and heterogeneous enhancement (63.2%) were the most common findings. No patients had regional lymphadenopathy. Complications occurred in four patients, with one each of bowel obstruction, intussusception, bile duct dilatation, and pancreatic duct dilatation. GI involvement of recurrent RCC could be included in the differential diagnosis of patients with heterogeneous, hyperenhanced intraluminal polypoid masses in the small bowel on CT scans along with a relative paucity of lymphadenopathy

  1. Digital assessment of lower rectum fixity in rectal prolapse (DALR): a simple clinical anatomical test to determine the most suitable approach (abdominal versus perineal) for repair.

    Science.gov (United States)

    Marzouk, Deya; Ramdass, Michael J; Haji, Amyn; Akhtar, Mansoor

    2005-12-01

    Selection of an appropriate approach to treat full thickness rectal prolapse remains problematic and controversial. We propose that rectal prolapse may be classified as 'low type' (true rectal prolapse) or 'high type' (intussusception of the sigmoid with a fixed lower rectum). This assessment can be made via a simple clinical test of digital rectal assessment of lower rectal fixity ('the hook test') based on anatomic changes in rectal prolapse to guide the selection process. In cases with the low-type prolapse, a perineal approach is appropriate (either Delorme's procedure, or rectosigmoidectomy with or without pelvic floor repair). For the high type, an abdominal rectopexy with or without high anterior resection is needed. Retrospective analysis of our cases treated over the last 6 years showed a recurrence rate of 6% in perineal procedures and 0% in abdominal rectopexy combined with resection to date. We believe that employing our simple test and classification can contribute to better patient selection for either approach, minimize anaesthetic and surgical risks and also result in lower recurrence rates.

  2. The postoperative stomach

    International Nuclear Information System (INIS)

    Woodfield, Courtney A.; Levine, Marc S.

    2005-01-01

    Gastric surgery may be performed for the treatment of a variety of benign and malignant diseases of the upper gastrointestinal tract, including peptic ulcers and gastric carcinoma. Radiographic studies with water-soluble contrast agents often are obtained to rule out leaks, obstruction, or other acute complications during the early postoperative period. Barium studies may also be obtained to evaluate for anastomotic strictures or ulcers, bile reflux gastritis, recurrent tumor, or other chronic complications during the late postoperative period. Cross-sectional imaging studies such as CT are also helpful for detecting abscesses or other postoperative collections, recurrent or metastatic tumor, or less common complications such as afferent loop syndrome or gastrojejunal intussusception. It is important for radiologists to be familiar not only with the radiographic findings associated with these various abnormalities but also with the normal appearances of the postoperative stomach on radiographic examinations, so that such appearances are not mistaken for pseudoleaks or other postoperative complications. The purpose of this article is to describe the normal postsurgical anatomy after the most commonly performed operations (including partial gastrectomy, esophagogastrectomy and gastric pull-through, and total gastrectomy and esophagojejunostomy) and to review the acute and chronic complications, normal postoperative findings, and major abnormalities detected on radiographic examinations in these patients

  3. CT features of appendiceal mucocele

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Won Jong; Byun, Jae Young; Jung, Jung Im; Lee, Hae Gyu; Park, Young Ha; Shin, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate the usefulness of CT features of appendiceal mucocele in the diagnosis and evaluation of complications. We retrospectively reviewed CT findings and compared with operative findings in 7 cases of pathologically proven appendiceal mucocele. CT findings such as location and extent of the lesion, tissue density, thickness or calcification of the wall, presence of adjacent inflammatory infiltration, and visualization of normal vermiform appendix were analyzed. Appendiceal mucocele was found as homogeneous low density cystic mass adjacent to the cecum, which has no surrounding inflammatory infiltration except in one case of perforation and one case of intussusception. Mean CT number measured in 4 cases was 21 Hounsfield unit. Thin curvilinear calcifications were noted along the cystic wall in 2 cases. Normal vermiform appendix couldn't be demonstrated in all cases. Appendiceal mucocele is characterized by homogeneously low density and thin walled cystic tumor adjacent to cecum without surrounding inflammatory infiltration, and absence of normal vermiform appendix on CT. Therefore, CT is valuable in preventing operative complications of appendiceal mucocele.

  4. The imaging of coeliac disease and its complications

    International Nuclear Information System (INIS)

    Buckley, O.; Brien, J.O.; Ward, E.; Doody, O.; Govender, P.; Torreggiani, W.C.

    2008-01-01

    Coeliac disease is a malabsorption syndrome in which dietary gluten damages the small bowel mucosa. Gluten contains gliadin, the primary toxic component that is primarily found in wheat, barley and rye products. The initial diagnosis of coeliac disease is usually made by endoscopic biopsy of the jejunum although sometimes imaging features can suggest the diagnosis. Once a diagnosis is made, patients need to be diet compliant and monitored for potential complications. Many complications are more common when dietary compliance is poor. Complications include intussusception (usually intermittent), ulcerative jejunitis, osteomalacia, cavitating lymph node syndrome and an increased risk of malignancies such as lymphoma, adenocarcinoma and squamous cell carcinoma. Radiological evaluation is central in the evaluation of these complications. Imaging may assist both in the diagnosis and staging of complications as well as enabling radiological guided percutaneous biopsy for complications of coeliac disease such as lymphoma. As coeliac disease is a relatively common disorder, it is likely that most radiologists will encounter the disease and its potential complications. The aim of this review article is to discuss and illustrate the role of modern radiology in evaluating the many presentations of this complex disease

  5. Ultrasound of selected pathologies of the small intestine

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2013-06-01

    Full Text Available Intestines, especially the small bowel, are rarely subject to US assessment due to the presence of gases and chyme. The aim of this paper was to analyze ultrasound images in selected pathologies of the small intestine in adults, including the aspects of differential diagnosis. Material and methods: In 2001–2012, abdominal ultrasound examinations were conducted in 176 patients with the following small bowel diseases: Crohn’s disease (n=35, small bowel obstruction (n=35, yersiniosis (n=28, infectious diarrhea (n=26, bacterial overgrowth syndrome (n=25, coeliac disease (n=15 and small bowel ischemia (n=12. During examinations patients were fasting and no other particular preparations were needed. Convex transducers of 3.5–6 MHz and linear ones of 7–12 MHz were used. The assessment of the small intestine in four abdominal quadrants constituted an integral element of the examination. The following features of the small bowel ultrasound presentation were subject to analysis: thickness and perfusion of the walls, presence of thickened folds in the jejunum, reduction of their number, presence of fluid and gas contents in the intestine, its peristaltic activity, jejunization of the ileum and enteroenteric intussusception. Furthermore, the size of the mesenteric lymph nodes and the width of the superior mesenteric artery were determined and the peritoneal cavity was evaluated in terms of the presence of free fluid. Results: Statistically significant differences were obtained between the thickness of the small intestine in Crohn’s disease or in ischemic conditions and the thickness in the remaining analyzed pathological entities. Small bowel obstruction was manifested by the presence of distended loops due to gas and fluid as well as by severe peristaltic contractions occurring periodically. In the course of ischemic disease, the intestinal walls were thickened without the signs of increased perfusion and

  6. Surgery for constipation: systematic review and practice recommendations: Results II: Hitching procedures for the rectum (rectal suspension).

    Science.gov (United States)

    Grossi, U; Knowles, C H; Mason, J; Lacy-Colson, J; Brown, S R

    2017-09-01

    To assess the outcomes of rectal suspension procedures (forms of rectopexy) in adults with chronic constipation. Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements with a summative Oxford Centre for Evidence-Based Medicine (2009) level. Eighteen articles were identified, providing data on outcomes in 1238 patients. All studies reported only on laparoscopic approaches. Length of procedures ranged between 1.5 to 3.5 h, and length of stay between 4 to 5 days. Data on harms were inconsistently reported and heterogeneous, making estimates of harm tentative and imprecise. Morbidity rates ranged between 5-15%, with mesh complications accounting for 0.5% of patients overall. No mortality was reported after any procedures in a total of 1044 patients. Although inconsistently reported, good or satisfactory outcome occurred in 83% (74-91%) of patients; 86% (20-97%) of patients reported improvements in constipation after laparoscopic ventral mesh rectopexy (LVMR). About 2-7% of patients developed anatomical recurrence. Patient selection was inconsistently documented. As most common indication, high grade rectal intussusception was corrected in 80-100% of cases after robotic or LVMR. Healing of prolapse-associated solitary rectal ulcer syndrome occurred in around 80% of patients after LVMR. Evidence supporting rectal suspension procedures is currently derived from poor quality studies. Methodologically robust trials are needed to inform future clinical decision making. © 2017 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

  7. Reactogenicity and safety of the human rotavirus vaccine, Rotarix™ in The Philippines, Sri Lanka, and India: a post-marketing surveillance study.

    Science.gov (United States)

    Bravo, Lulu; Chitraka, Amarjeet; Liu, Aixue; Choudhury, Jaydeep; Kumar, Kishore; Berezo, Lennie; Cimafranca, Leonard; Chatterjee, Pallab; Garg, Pankaj; Siriwardene, Prasanna; Bernardo, Rommel; Mehta, Shailesh; Balasubramanian, Sundaram; Karkada, Naveen; Htay Han, Htay

    2014-01-01

    Regulatory bodies in The Philippines, Sri Lanka, and India require post-marketing surveillance to provide additional safety data on Rotarix™ in real-life settings. In such studies conducted in The Philippines (November 2006 to July 2012; NCT00353366), Sri Lanka (November 2008 to August 2009; NCT00779779), and India (August 2009 to April 2010; NCT00938327), 2 doses of Rotarix™ were administered according to the local prescribing information (PI). The occurrence of at least Grade "2"/"3" solicited adverse event (AE) (fever, vomiting, or diarrhea), within 15 days in The Philippines or 8 days in Sri Lanka and India; unsolicited AEs within 31 days and serious adverse events (SAEs) throughout the study were recorded. Of the 1494, 522, and 332 infants enrolled in The Philippines, Sri Lanka, and India, 14.7% 14.9% and 12.7% infants, respectively recorded at least Grade "2"/"3" solicited AEs. The most commonly reported solicited AEs were irritability in The Philippines (32.2% post-Dose-1; 23.5% post-Dose-2) and India (23.0% post-Dose-1; 13.2% post-Dose-2), and fever (18.0% post-Dose-1; 20.2% post-Dose-2) in Sri Lanka. Unsolicited AEs were recorded in 24.5% (The Philippines), 4.8% (Sri Lanka), and 6.9% (India) of infants. Forty-one SAEs were recorded in the Philippines of which 6 (decreased oral intake with increased sleeping time and constipation; pneumonia, urinary tract infection, and intussusception) were considered by the investigators as causally related to vaccination. One vaccine-unrelated SAE occurred in a Sri Lankan infant. All SAEs resolved and the infants recovered. Two doses of Rotarix™, administered to healthy infants according to local PI, were well tolerated in The Philippines, Sri Lanka, and India.

  8. Functional consequences of prolactin signalling in endothelial cells: a potential link with angiogenesis in pathophysiology?

    Science.gov (United States)

    Reuwer, Anne Q; Nowak-Sliwinska, Patrycja; Mans, Laurie A; van der Loos, Chris M; von der Thüsen, Jan H; Twickler, Marcel Th B; Spek, C Arnold; Goffin, Vincent; Griffioen, Arjan W; Borensztajn, Keren S

    2012-01-01

    Prolactin is best known as the polypeptide anterior pituitary hormone, which regulates the development of the mammary gland. However, it became clear over the last decade that prolactin contributes to a broad range of pathologies, including breast cancer. Prolactin is also involved in angiogenesis via the release of pro-angiogenic factors by leukocytes and epithelial cells. However, whether prolactin also influences endothelial cells, and whether there are functional consequences of prolactin-induced signalling in the perspective of angiogenesis, remains so far elusive. In the present study, we show that prolactin induces phosphorylation of ERK1/2 and STAT5 and induces tube formation of endothelial cells on Matrigel. These effects are blocked by a specific prolactin receptor antagonist, del1-9-G129R-hPRL. Moreover, in an in vivo model of the chorioallantoic membrane of the chicken embryo, prolactin enhances vessel density and the tortuosity of the vasculature and pillar formation, which are hallmarks of intussusceptive angiogenesis. Interestingly, while prolactin has only little effect on endothelial cell proliferation, it markedly stimulates endothelial cell migration. Again, migration was reverted by del1-9-G129R-hPRL, indicating a direct effect of prolactin on its receptor. Immunohistochemistry and spectral imaging revealed that the prolactin receptor is present in the microvasculature of human breast carcinoma tissue. Altogether, these results suggest that prolactin may directly stimulate angiogenesis, which could be one of the mechanisms by which prolactin contributes to breast cancer progression, thereby providing a potential tool for intervention. PMID:22128761

  9. Meckel′s diverticulum in paediatric practice on Crete (Greece: A 10-year review

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    Evangelos Blevrakis

    2011-01-01

    Full Text Available Background: Although Meckel′s diverticulum (MD is the most prevalent congenital abnormality of the gastrointestinal tract, it has varied presentations and often becomes a diagnostic challenge. The purpose of this study was to review the diverse presentations of MD, record the epidemiologic features for Crete and review the detection techniques and the treatment options. Patients and Methods: This was a review of the records of all children who underwent surgery for MD in the department of Paediatric Surgery of the University Hospital of Crete (Greece between January 1999 and January 2009. Result: A total of 45 patients (32 male and 13 female aged 1 to 13 years (median 10 years with a diagnosis of MD were retrospectively reviewed. The collected data were analysed, looking at age, gender, clinical features, investigations, histopathological findings and surgical interventions. In 25 patients, MD was an incidental finding at laparotomy because of appendicitis. The remaining 20 patients were symptomatic and presented with various clinical features. Nine patients (19.9% had clinical features of peritonitis; of these, three had perforated MD and six had Meckel′s diverticulitis at laparotomy. Four patients were diagnosed with intestinal obstruction. Seven patients (15.5% presented with lower gastrointestinal bleeding. Ultrasound scans revealed intussusception in three patients, requiring open reduction. The remaining four patients with bleeding per rectum underwent a Meckel′s Tc99 scan that showed a positive tracer. Conclusion: All patients with MD underwent Meckel′s diverticulectomy with appendicectomy. MD has an incidence of approximately 1 to 2% in our population. It is necessary to maintain a high index of suspicion in the in the diagnosis of MD paediatric age group because it can be easily misdiagnosed.

  10. [Examples for vaccines against diarrheal diseases--rotavirus and traveller's diarrhea].

    Science.gov (United States)

    Kollaritsch, Herwig; Wiedermann, Ursula

    2007-01-01

    disease and an excellent tolerability with no difference in side reactions to the placebo controls, particularly with respect to intussusceptions.

  11. CLINICAL, EPIDEMIOLOGIC, AND ENDOSCOPIC PROFILE IN CHILDREN AND ADOLESCENTS WITH COLONIC POLYPS IN TWO REFERENCE CENTERS

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    Denise O ANDRADE

    2015-12-01

    Full Text Available Background - The main goal of this paper is to investigate the frequency, clinical profile, and endoscopic findings of children and teenagers submitted to colonoscopies. Methods - Patients of below 18 years of age, diagnosed with polyps by means of colonoscopies at two reference centers of pediatric endoscopy were followed-up between 2002 and 2012. The clinical variables evaluated in this study included: gender, recommendation of colonoscopy, associated signs and symptoms, age of onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of intestinal polyposis and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, histology, and distribution. Polyposis syndromes were also investigated. Results - From the 233 patients submitted to colonoscopies, polyps were found in 74 (31.7% patients, with a median age of 6.6 years, of which 61% were male. Juvenile polyps were identified in 55 (74% patients, with 7 (9% characterized within the criteria for juvenile polyposis. Patients with intestinal polyposis syndromes were diagnosed in 35% of the patients. The most frequent clinical presentation was hematochezia. Abdominal pain with acute episodes of intestinal partial obstruction or intussusception with emergency laparotomy was observed in the majority of Peutz-Jeghers syndrome patients leading to an increased morbidity. Conclusions - Even though juvenile colonic polyps are the most frequent type of diagnosed polyps, the present study identified a significant level of children with polyposis syndromes (35%, associated with a higher morbidity of these individuals.

  12. Tolerance of canine anastomoses to intraoperative radiation therapy

    International Nuclear Information System (INIS)

    Tepper, J.E.; Sindelar, W.; Travis, E.L.; Terrill, R.; Padikal, T.

    1983-01-01

    Radiation has been given intraoperatively to various abdominal structures in dogs, using a fixed horizontal 11 MeV electron beam at the Armed Forces Radiobiologic Research Institute. Animals were irradiated with single doses of 2000, 3000 and 4500 rad to a field which extended from the bifurcation of the aorta to the rib cage. All animals were irradiated during laparotomy under general anesthesia. Because the clinical use of intraoperative radiotherapy in cancer treatment will occasionally require irradiation of anastomosed large vessels and blind loops of bowel, the tolerance of aortic anastomoses and the suture lines of blind loops of jejunum to irradiation were studied. Responses in these experiments were scored at times up to one year after irradiation. In separate experiments both aortic and intestinal anastomoses were performed on each animal for evaluation of short term response. The dogs with aortic anastomoses showed adequate healing at all doses with no evidence of suture line weakening. On long-term follow-up one animal (2000 rad) had stenosis at the anastomosis and one animal (4500 rad) developed an arteriovenous fistula. Three of the animals that had an intestinal blind loop irradiated subsequently developed intussusception, with the irradiated loop acting as the lead point. One week after irradiation, bursting pressure of an intestinal blind loop was normal at 3000 rad, but markedly decreased at 4500 rad. No late complications were noted after the irradiation of the intestinal anastomosis. No late complicatons were observed after irradiation of intestinal anastomoses, but one needs to be cautious with regards to possible late stenosis at the site of an irradiated vascular anastomosis

  13. Pharmacological Modulation of Hemodynamics in Adult Zebrafish In Vivo.

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    Daniel Brönnimann

    Full Text Available Hemodynamic parameters in zebrafish receive increasing attention because of their important role in cardiovascular processes such as atherosclerosis, hematopoiesis, sprouting and intussusceptive angiogenesis. To study underlying mechanisms, the precise modulation of parameters like blood flow velocity or shear stress is centrally important. Questions related to blood flow have been addressed in the past in either embryonic or ex vivo-zebrafish models but little information is available for adult animals. Here we describe a pharmacological approach to modulate cardiac and hemodynamic parameters in adult zebrafish in vivo.Adult zebrafish were paralyzed and orally perfused with salt water. The drugs isoprenaline and sodium nitroprusside were directly applied with the perfusate, thus closely resembling the preferred method for drug delivery in zebrafish, namely within the water. Drug effects on the heart and on blood flow in the submental vein were studied using electrocardiograms, in vivo-microscopy and mathematical flow simulations.Under control conditions, heart rate, blood flow velocity and shear stress varied less than ± 5%. Maximal chronotropic effects of isoprenaline were achieved at a concentration of 50 μmol/L, where it increased the heart rate by 22.6 ± 1.3% (n = 4; p < 0.0001. Blood flow velocity and shear stress in the submental vein were not significantly increased. Sodium nitroprusside at 1 mmol/L did not alter the heart rate but increased blood flow velocity by 110.46 ± 19.64% (p = 0.01 and shear stress by 117.96 ± 23.65% (n = 9; p = 0.03.In this study, we demonstrate that cardiac and hemodynamic parameters in adult zebrafish can be efficiently modulated by isoprenaline and sodium nitroprusside. Together with the suitability of the zebrafish for in vivo-microscopy and genetic modifications, the methodology described permits studying biological processes that are dependent on hemodynamic alterations.

  14. Polyposis syndromes in children and adolescents: a case series data analysis.

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    Cohen, Shlomi; Gorodnichenco, Anna; Weiss, Batia; Lerner, Aaron; Ben-Tov, Amir; Yaron, Ayala; Reif, Shimon

    2014-09-01

    Polyposis syndromes in children are distinct entities clinically and pathologically. These syndromes have multiple genetic characteristics, with development of polyps at various sites of the gastrointestinal (GI) tract, and are associated with an increased risk of colon cancer. They are relatively rare, and have mostly been characterized in the adult population, whereas little epidemiologic data have been reported in children. The aim of this study was to summarize the pediatric experience collected over a period of 11 years on polyposis syndromes in three major Israeli tertiary centers. Medical records of children below 18 years old and their families, diagnosed with polyposis syndromes between 1999 and 2010, were reviewed. The data included disease presentation, genetic profile, surveillance, and treatment. Fifty patients with polyposis syndromes were identified. The most frequent syndrome was familial adenomatous polyposis (FAP) in 33 children (66%), of whom 25 children (75.7%) had a known mutation. The mean age at presentation was 10.6±3.9 years (range 4-17 years). Most children were examined because of a family history of a polyposis syndrome (42 children, 84%). Among symptomatic children (32 children), the most frequent complaint was rectal bleeding (42%), followed by abdominal pain (22%), intussusception (10%), and diarrhea (4%). The youngest symptomatic patient was 4 years old at presentation, with rectal bleeding.All patients underwent multiple colonoscopies and upper GI endoscopies according to specific guidelines. Thirteen children underwent colonic surgery (39%); nine children had FAP. Adenocarcinoma of the colon was diagnosed in a 12.5-year-old child. In this cohort study, FAP was the most common type of polyposis syndrome diagnosed in this pediatric population. Colon cancer was present at the onset of symptoms in a 12.5-year-old patient with FAP. We therefore recommend strict adherence to the hereditary GI cancer guidelines to prevent morbidity and

  15. [Hydrocolonic sonography--potentials and limitations of ultrasonographic diagnosis of colon diseases].

    Science.gov (United States)

    Limberg, B

    2001-12-01

    Hydrocolonic sonography - potentials and limitations of ultrasonographic diagnosis of colon diseases. Ultrasonic examination has become increasingly important in the diagnosis of diseases of the gastrointestinal tract. In neoplastic diseases of the large intestine, however, the diagnostic value of conventional transabdominal sonography is limited. The sonographic evaluation of the colon could be improved by the retrograde instillation of water into the colon in a procedure called hydrocolonic sonography. This technique allows the visualization of the colon sonographically from the rectosigmoid transition to the cecum. Hydrocolonic sonography enables a detailed sonographic examination of the hypoechoic colonic lumen, the five individual layers of the colon wall and the surrounding connective tissue, thus providing additional information and allowing a more precise diagnosis of many diseases of the colon. Colonic polyps and carcinomas appear sonographically as echogenic structures projecting from the intestinal wall into the lumen. Colonic polyps larger than 7 mm in diameter and carcinomas of the colon can be detected with great sensitivity. In addition, detailed evaluation of the structure of the bowel wall permits more precise staging of tumors of the colon. Aside from such localized changes, hydrocolonic sonography can also demonstrate changes in the wall structure in chronic inflammatory large bowel diseases such as Crohn's disease and ulcerative colitis. In addition hydrocolonic sonography has been proven to be of great value for the ultrasonographically-guided hydrostatic reduction of intussusception in children. On the other hand virtual colonoscopy is another promising new imaging method for the diagnosis of colon diseases. The differences between hydrcolonic sonography and virtual colonoscopy and their potential for screening purposes of colon cancer will be discussed.

  16. Feasibility of video capsule endoscopy in the management of children with Peutz-Jeghers syndrome: a blinded comparison with barium enterography for the detection of small bowel polyps.

    Science.gov (United States)

    Postgate, Aymer; Hyer, Warren; Phillips, Robin; Gupta, Arun; Burling, David; Bartram, Clive; Marshall, Michelle; Taylor, Stuart; Brown, Gregor; Schofield, Gill; Bassett, Paul; Spray, Christine; Fitzpatrick, Aine; Latchford, A; Fraser, Chris

    2009-10-01

    Peutz-Jeghers syndrome (PJS) in children may present with anaemia, intussusception, or obstruction from an early age and surgery is common. Prophylactic polypectomy may reduce subsequent complications. Traditional barium enterography (BE) has poor sensitivity and requires significant radiation. We compared the performance of capsule endoscopy (CE) with BE in children with PJS. Children with PJS (ages 6.0-16.5 years) were prospectively recruited and underwent BE followed by CE, each reported by expert reviewers blinded to the alternate modality. Number of "significant" (>10 mm) and total number of polyps were recorded. Child preference was assessed using a visual analogue questionnaire. Definitive findings were assessed at laparotomy or enteroscopy, when performed. There was no significant difference for >10 mm polyp detection. Six polyps were found in 3 children by both modalities: 3 polyps in 2 children at CE, 3 polyps in 1 child at BE (P=0.50). Re-review of 1 CE identified 3 polyps that were missed in 1 child at initial reading. Significantly more polyps were identified by CE than BE: 61 vs 6 (P=0.02). CE was significantly more comfortable than BE (median score CE 76 [interquartile range 69-87] vs BE 37 [interquartile range 31-68], P=0.03) and was the preferred investigation in 90% (P=0.02). CE is a feasible, safe, and sensitive test for small bowel polyp surveillance in children with PJS. It is significantly more comfortable than BE and is the preferred test of most children for future surveillance. There is a learning curve for reporting CE studies in PJS and appropriate training is essential.

  17. Usefulness of helical CT in the diagnosis of strangulation in small bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Young Hye; Kim, Won Hong; Jeon, Yong Sun; Shin, Dong Jae; Cho, Soon Gu; Lee, Chang Keun; Choi, Sun Keun [College of Medicine, Inha Univ., Incheon (Korea, Republic of)

    2004-12-01

    We wished to evaluate the usefulness of helical CT for the diagnosis of strangulation of the dilated small bowels. The CT scans of 31 patients with small bowel obstruction from various causes were reviewed retrospectively. Thirteen of these patients were confirmed as small bowel strangulation by surgery and pathology. Fourteen patients underwent surgery, but they had no strangulation. Three patients were reduced by using a nasogastric tube and one infant with intussusception was reduced by air reduction. The following CT findings of strangulation were evaluated: reduced bowel wall enhancement by visual assessment and measuring the HU, ascites, thickening of bowel wall, abnormal mesenteric vessel location and whirlpool appearance, and mesenteric venous engorgement. For the precise evaluation of reduced bowel wall enhancement, the HUs were measured by 1 mm{sup 2} of ROI, and the differences of HUs between the well enhanced bowel and poorly enhanced bowel were compared. For the diagnosis of strangulation, measurement of HU of the bowel wall could improve the sensitivity from 69% to 100%. The specificity of both methods, by visual assessment and measurement of HU, was 94%. Ascites had a sensitivity of 69% and specificity of 44%. Thickening of bowel wall had a sensitivity of 38% and specificity of 78%. Abnormal mesenteric vessel location and whirlpool appearance had a sensitivity of 38% and specificity of 83%. Mesenteric venous engorgement had a sensitivity of 31% and specificity of 72%. Measurement of HU of the bowe wall after contrast enhancement can be a useful method in the differential diagnosis between the strangulated and non-strangulated bowels in patients with small bowel obstruction.

  18. Emergency management of acute abdomen in children.

    Science.gov (United States)

    Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

    2013-03-01

    Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology.

  19. Acute complications after laparoscopic bariatric procedures: update for the general surgeon.

    Science.gov (United States)

    Campanile, Fabio Cesare; Boru, Cristian E; Rizzello, Mario; Puzziello, Alessandro; Copaescu, Catalin; Cavallaro, Giuseppe; Silecchia, Gianfranco

    2013-06-01

    Development and widespread use of laparoscopic bariatric surgery exposes emergency room physicians and general surgeons to face acute or chronic surgical complications of bariatric surgery. The most common surgical emergencies after bariatric surgery are examined based on an extensive review of bariatric surgery literature and on the personal experience of the authors' practice in four high-volume bariatric surgery centers. An orderly stepwise approach to the bariatric patient with an emergency condition is advisable. Resuscitation should follow the same protocol adopted for the non-bariatric patients. Consultation with the bariatric surgeon should be obtained early, and referral to the bariatric center should be considered whenever possible. The identification of the surgical procedure to which the patient was submitted will orient in the diagnosis of the acute condition. Procedure-specific complication should always be taken into consideration in the differential diagnosis. Acute slippage is the most frequent complication that needs emergency treatment in a laparoscopic gastric banding. Sleeve gastrectomy and gastric bypasses may present with life-threatening suture leaks or suture line bleeding. Gastric greater curvature plication (investigational restrictive procedure) can present early complications related to prolonged postoperative vomiting. Both gastric bypass and bilio-pancreatic diversion may cause anastomotic marginal ulcer, bleeding, or rarely perforation and severe stenosis, while small bowel obstruction due to internal hernia represents a surgical emergency, also caused by trocar site hernia, intussusceptions, adhesions, strictures, kinking, or blood clots. Rapid weight loss after bariatric surgery can cause cholecystitis or choledocholithiasis, which are difficult to treat after bypass procedures. The general surgeon should be informed about modern bariatric procedures, their potential acute complications, and emergency management.

  20. Gastrointestinal and nutritional issues in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Pascolini, Giulia; Blundo, Carlo; Grammatico, Paola

    2015-03-01

    Gastrointestinal involvement is a well known complication of Ehlers-Danlos syndromes (EDSs), mainly in form of abdominal emergencies due to intestinal/abdominal vessels rupture in vascular EDS. In the last decade, a growing number of works investigated the relationship between a wide spectrum of chronic gastrointestinal complaints and various EDS forms, among which the hypermobility type (a.k.a. joint hypermobility syndrome; JHS/EDS-HT) was the most studied. The emerging findings depict a major role for gastrointestinal involvement in the health status and, consequently, management of JHS/EDS-HT patients. Nevertheless, fragmentation of knowledge limits its impact on practice within the boundaries of highly specialized clinics. In this paper, literature review on gastrointestinal manifestations in JHS/EDS-HT was carried out and identified papers categorized as (i) case-control/cohort studies associating (apparently non-syndromic) joint hypermobility and gastrointestinal involvement, (ii) case-control/cohort studies associating JHS/EDS-HT and gastrointestinal involvement, (iii) case reports/series on various gastrointestinal complications in (presumed) JHS/EDS-HT, and (iv) studies reporting gastrointestinal features in heterogeneous EDS patients' cohorts. Gastrointestinal manifestations of JHS/EDS-HT were organized and discussed in two categories, including structural anomalies (i.e., abdominal/diaphragmatic hernias, internal organ/pelvic prolapses, intestinal intussusceptions) and functional features (i.e., dysphagia, gastro-esophageal reflux, dyspepsia, recurrent abdominal pain, constipation/diarrhea), with emphasis on practice and future implications. In the second part of this paper, a summary of possible nutritional interventions in JHS/EDS-HT was presented. Supplementation strategies were borrowed from data available for general population with minor modifications in the light of recent discoveries in the pathogenesis of selected JHS/EDS-HT features. © 2015

  1. Fasting for haemostasis in children with gastrointestinal bleeding.

    Science.gov (United States)

    Luo, Shuang-Hong; Guo, Qin; Liu, Guan J; Wan, Chaomin

    2016-05-19

    Gastrointestinal bleeding refers to loss of blood from any site of the digestive tract. In paediatric clinical practice, it is usually a complaint of children attending the emergency department as a symptom of diseases such as ulcers, gastric or oesophageal varices, gastritis, Mallory-Weiss tears, anorectal fissures, allergic colitis, infectious colitis, intussusception, Henoch-Schonlein purpura, and Meckel's diverticulum; it also occurs with high incidence in critically ill children hospitalised in intensive care units and is caused by stress-induced gastropathy. No matter what the cause of gastrointestinal bleeding, fasting is believed to be necessary due to the fear that eating may affect haemostasis or aggravate bleeding. To assess the effects and safety of fasting for haemostasis in gastrointestinal bleeding in children. We searched EBM Reviews - the Cochrane Central Register of Controlled Trials (CENTRAL) (May 2016), Ovid MEDLINE(R) (1946 to 3 May 2016), EMBASE (1980 to 2016 Week 18), Chinese Biomedical Database (CBM) (1978 to 3 May 2016), China National Knowledge Infrastructure (CNKI) (1979 to 3 May 2016), VIP Database (1989 to 4 May 2016) and Wanfang Data (1990 to 4 May 2016). We used no restrictions on language or study setting and limited searches in CNKI and Wanfang Data to the medical field. Randomised controlled trials (RCTs) or quasi-RCTs in children with gastrointestinal bleeding that compared fasting with feeding. Two review authors independently screened the literature search results, and there were no disagreements. We identified no RCTs or quasi-RCTs that compared the effects and safety of fasting with feeding for haemostasis in children with gastrointestinal bleeding. No study fulfilled the criteria for considering studies for our review. There is currently no information available from RCTs or quasi-RCTs to support or refute the use of fasting for haemostasis in children with gastrointestinal bleeding.

  2. Causes of colic and types requiring surgical intervention.

    Science.gov (United States)

    Wheat, J D

    1975-03-01

    The migration of strongyle larvae is the most common or basic underlying cause of colic in the horse. Disease conditions producing symptoms of colic occur in all sections of the intestinal tract and consist of impactions, torsions, herniations and foreign bodies. Colic also occurs as a result of pre- and post-partum diseases such as torsion of the uterus, haemorrhage, rupture and inversion of the uterus. In general, lesions resulting in circulatory obstruction are the types requiring surgical intervention. There are six general types of small intestine obstruction that lend themselves to surgical treatment; namely, volvulus, herniations, intussusceptions, stenosis of the lumen of the bowel by external bands or by foreign bodies and chronic inflammatory lesions. The large intestine is not subject to the variety of obstructive lesions found in the small intestine. Impactions count for a large percentage of the obstructions seen. A standing laparotomy for diagnostic purposes may be indicated. Small colon impactions are readily treated by standing laparotomy. Enteroliths are of very common occurrence in some areas of the country; they often result in rupture of the colon. Torsions of the colon produce septic shock very rapidly. The left dorsal colon moving medially or laterally and ventrally initiates the torsion. Clockwise rotation is most common. Massive intravenous therapy is needed to maintain hydration. Ventral midline laparotomy gives best access. Surgery must be performed very early to avoid massive tissue necrosis. Survival rate is 30 percent or less. The small colon is also capable of rotation and volvulus, and of strangulation in the umbilical or inguinal ring.

  3. Appendiceal Adenocarcinoma Presenting as a Rectal Polyp

    Directory of Open Access Journals (Sweden)

    Erin Fitzgerald

    2016-02-01

    Full Text Available Appendiceal adenocarcinoma typically presents as an incidentally noted appendiceal mass, or with symptoms of right lower quadrant pain that can mimic appendicitis, but local involvement of adjacent organs is uncommon, particularly as the presenting sign. We report on a case of a primary appendiceal cancer initially diagnosed as a rectal polyp based on its appearance in the rectal lumen. The management of the patient was in keeping with standard practice for a rectal polyp, and the diagnosis of appendiceal adenocarcinoma was made intraoperatively. The operative strategy had to be adjusted due to this unexpected finding. Although there are published cases of appendiceal adenocarcinoma inducing intussusception and thus mimicking a cecal polyp, there are no reports in the literature describing invasion of the appendix through the rectal wall and thus mimicking a rectal polyp. The patient is a 75-year-old female who presented with spontaneous hematochezia and, on colonoscopy, was noted to have a rectal polyp that appeared to be located within a diverticulum. When endoscopic mucosal resection was not successful, she was referred to colorectal surgery for a low anterior resection. Preoperative imaging was notable for an enlarged appendix adjacent to the rectum. Intraoperatively, the appendix was found to be densely adherent to the right lateral rectal wall. An en bloc resection of the distal sigmoid colon, proximal rectum and appendix was performed, with pathology demonstrating appendiceal adenocarcinoma that invaded through the rectal wall. The prognosis in this type of malignancy weighs heavily on whether or not perforation and spread throughout the peritoneal cavity have occurred. In this unusual presentation, an en bloc resection is required for a complete resection and to minimize the risk of peritoneal spread. Unusual appearing polyps do not always originate from the bowel wall. Abnormal radiographic findings adjacent to an area of

  4. Defecography of rectal wall prolapse conditions; Defecografia nelle malattie parietali del retto da prolasso

    Energy Technology Data Exchange (ETDEWEB)

    Salzano, A.; Muto, M.; De Rosa, A. [Azienda Sanitaria di Rilievo Nazionale A. Cardarelli, Naples (Italy). Servizio di Neuroradiologia; Ginolfi, F.; Carbone, M.; Amodio, F.; Rossi, E. [Naples Univ. Federico 2. (Italy). Ist. di Scienze Radiologiche; Tuccillo, M. [Azienda Sanitaria di Rilirvo Nazionale A. Cardarelli, Naples (Italy). 2. Servizio di Radiologia

    1999-06-01

    Pelvic floor and rectal prolapse conditions have greatly benefited by new imaging and instrumental diagnostic approaches, and especially defecography, for both pathophysiological interpretation and differential diagnosis. The authors investigated the efficacy of defecography in the assessment of rectal prolapse, and in particular the role of videproctography in diagnosis such dynamic disorders. The dynamic changes of ampulla are well depicted by videoproctography, which showed anorectum normalization and spontaneous reduction of invagination after intussusception. Defecography exhibited good capabilities in showing rectal wall function abnormalities. Finally, some features of videoproctography such as low radiation dose, non-invasiveness and ease of execution, make the examination acceptable to patients with anorectal disorders and for the follow-up of rectal prolapse. [Italian] Le malattie del pavimento pelvico e dei prolassi del retto hanno tratto numerosi vantaggi da nuovi approcci di diagnostica per immagini e strumentali, specialmente dall'esame defecografico, sia nell'interpretazione fisiopatologica che nella diagnostica differenziale dei disordini anorettali. Scopo del lavoro: valutare l'efficacia della metodica defecografica nel riconoscimento delle malattie da prolasso del retto e in particolare il ruolo svolto dalla videoproctografia nella documentazione diagnostica e nel definire i principali elementi semeiologici riscontrabili in tali malattie in modo dinamico. Le fasi dinamiche della valutazione morfologica e posizionale dell'ampolla rettale sono ben evidenti nella viedeoproctografia, che documenta dopo l'intussuscezione la normalizzazione del complesso anorettale e la riduzione spontanea dell'invaginazione parietale. In questo studio si sottolineano le possibilita' diagnostiche della defecografia integrata da videoproctografia nel riconoscimento delle malattie parietali funzionali del retto e alcune peculiarita

  5. RotaTeq: Progress toward developing world access.

    Science.gov (United States)

    Goveia, Michelle G; Nelson, Christopher B; Ciarlet, Max

    2010-09-01

    Phase III studies of an oral, live, pentavalent, human-bovine reassortant rotavirus vaccine (RotaTeq; Merck) in developed countries have demonstrated that it is well tolerated with regard to intussusception and other adverse events and is efficacious in preventing rotavirus gastroenteritis and associated healthcare encounters. However, it cannot be assumed that rotavirus vaccines will be equally efficacious in infants and young children in the developing world. Differences in host populations, associated health conditions, and the epidemiology of rotavirus disease could affect vaccine performance. Concern about the potential for differences in efficacy stems from studies of previous candidate rotavirus vaccines, including bovine and rhesus rotaviruses, which showed no or variable efficacy in developing regions. Given this history, the World Health Organization (WHO) recommended that the efficacy of "new" rotavirus vaccines should be demonstrated in diverse geographic areas, including developing countries, before widespread implementation. Successful implementation of any rotavirus vaccine in the developing world requires additional clinical research and sharing of early introduction experiences. We discuss efforts to bring RotaTeq vaccine to the developing world. Critical steps to achieve this goal include the clinical evaluation of vaccine safety and efficacy in a multisite trial in Asia and Africa, evaluation of concomitant use with other pediatric vaccines routinely used, and vaccine assessment in special populations (premature, human immunodeficiency virus-infected, and malnourished infants). Completion of WHO prequalification of RotaTeq and affordability are also key requirements to routine vaccine introduction. The RotaTeq Partnership with the Nicaraguan Ministry of Health provides an example of the successful introduction of this vaccine into a developing world country.

  6. Soave transanal one-stage endorectal pull-through in the treatment of Hirschsprung′s disease of the child above two-year-old: A report of 20 cases

    Directory of Open Access Journals (Sweden)

    Amine Ksia

    2013-01-01

    Full Text Available Background: The definitive treatment of Hirschsprung′s disease is the removal of the aganglionic bowel by a pull-through surgery. In most cases, this surgery is performed in infancy or in the neonatal period as presentation in older children and adulthood is uncommon. Materials and Methods: It is a retrospective study of 20 patients above two-year-old who underwent a transanal Soave one-stage endorectal pull-through procedure for Hirschsprung′s disease between January 2002 and December 2010. Results: Twenty patients were recruited in this study. Fourteen were males and six were females. Patient ages ranged from 2 to 14 years (median age: five years and three months. All patients presented with persistent constipation and abdominal distension. Two of them had an intestinal obstruction that required colostomy. Ten patients (50% had a recto-sigmoid Hirschsprung′s disease. All patients were operated on using a Soave one-stage endorectal pull-through procedure. The laparoscopy was necessary during the pull-through in three cases. The average duration of the intervention was 240 minutes. That represents almost the double of the duration of the same procedure in newborns and infants in our department (130 minutes. Early postoperative complications included one case of anastomosis leakage and one case of intussusception. Late postoperative complications were perineum irritation in five cases (25%, anal stenosis in four cases (20% and enterocolitis in one case (5%. None of our patients developed fecal incontinence. Soiling was reported in four cases (20%. There was no death. Conclusion: Soave transanal one-stage endorectal pull-through is safely feasible in children of more than two years of age. Laparoscopy may be necessary whenever there are difficulties in the pull-through.

  7. Appendiceal Mucocele in an Elderly Patient: How Much Surgery

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    C. Kim-Fuchs

    2011-09-01

    Full Text Available Appendiceal mucoceles are rare cystic lesions with an incidence of 0.3–0.7% of all appendectomies. They are divided into four subgroups according to their histology. Even though the symptoms may vary – depending on the level of complication – from right lower quadrant pain, signs of intussusception, gastrointestinal bleeding to an acute abdomen with sepsis, most mucoceles are asymptomatic and found incidentally. We present the case of a 70-year-old patient with an incidentally found appendiceal mucocele. He was seen at the hospital for backache. The CT scan showed a vertebral fracture and a 7-cm appendiceal mass. A preoperative colonoscopy displayed several synchronous adenomas in the transverse and left colon with high-grade dysplasia. In order to lower the cancer risk of this patient, we performed a subtotal colectomy. The appendiceal mass showed no histopathological evidence of malignancy and no sign of perforation. The follow-up was therefore limited to 2 months. In this case, appendectomy would have been sufficient to treat the mucocele alone. The synchronous high-grade dysplastic adenomas were detected in the preoperative colonoscopy and determined the therapeutic approach. Generally, in the presence of positive lymph nodes, a right colectomy is the treatment of choice. In the histological presence of mucinous peritoneal carcinomatosis, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is indicated. In conclusion, mucoceles of the appendix are detected with high sensitivity by CT scan. If there is no evidence of synchronous tumor preoperatively and no peritoneal spillage, invasion or positive sentinel lymph nodes during surgery, a mucocele is adequately treated by appendectomy.

  8. Neonatal morbidity and mortality of 31 calves derived from somatic cloning.

    Science.gov (United States)

    Brisville, A-C; Fecteau, G; Boysen, S; Desrochers, A; Dorval, P; Buczinski, S; Lefebvre, R; Hélie, P; Blondin, P; Smith, L C

    2013-01-01

    The neonatal period is associated with high morbidity and mortality in cloned calves. To describe morbidity and mortality in cloned calves from birth to 2 years of age. Thirty-one somatic cell-derived Holstein calves delivered at a veterinary teaching hospital. Medical files were retrospectively analyzed. Four calves were stillborn. Five calves born alive had physical congenital defects. Twenty-three calves had an enlarged umbilical cord. Laboratory abnormalities included acidemia, respiratory acidosis, hyperlactatemia, anemia, stress leukogram, decreased total protein, albumin and globulins, and increased creatinine. Twenty-five calves survived the 1st hour of life. Among them, 11 stood without assistance within 6 hours of birth, 10 calves took longer than 6 hours to stand, and 4 never stood. Twenty-two calves suffered from anorexia. Twelve calves had complications arising from umbilical cord infections. Three calves developed idiopathic hyperthermia (>40°C). Eight calves suffered from gastrointestinal problems, including ruminal distension, abomasal ulcers, neonatal enteritis, intussusception, and abomasal displacement. Mortality between birth and 3 weeks of age was 32% (10/31). Causes of death and reasons for euthanasia included stillbirths, respiratory failure, and limb deformities. Mortality between 3 weeks and 2 years of age was 19% (4/21), with deaths in this group attributed to generalized peritonitis and complications arising from umbilical infections. Overall, mortality rate within 2 years of age was 14/31 (45%). Respiratory problems, limb deformities, and umbilical infections were the most common causes of morbidity and mortality in these cloned calves. Copyright © 2013 by the American College of Veterinary Internal Medicine.

  9. Bedside Ultrasound for the Diagnosis of Small Bowel Obstruction

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    Alexander Anshus

    2017-09-01

    Full Text Available History of present illness: An elderly female with no history of prior abdominal surgeries presented to the emergency department (ED with acute onset of abdominal pain and distention. Upon arrival, she began having large volume bilious emesis. While waiting for a computed tomography (CT scan of her abdomen and pelvis, a point of care ultrasound (POCUS was performed which showed evidence of a small bowel obstruction (SBO. The patient had a nasogastric tube placed that put out over two liters of bilious contents. A subsequent CT scan confirmed the diagnosis of SBO from a left inguinal hernia and the patient was admitted to the surgical service. Significant findings: The POCUS utilizing the low frequency curvilinear probe demonstrates fluid-filled, dilated bowel loops greater than 2.5cm with to-and-fro peristalsis, and thickened bowel walls greater than 3mm, concerning for SBO. Discussion: Gastrointestinal obstruction is a common diagnosis in the ED, accounting for approximately 15% of all ED visits for acute abdominal pain.1 SBO accounts for approximately 80% of all obstructions.2 In the diagnosis of SBO, studies show that abdominal x-rays have a sensitivity of 66-77% and specificity of 50-57%,3 CT scans have a sensitivity of 92% and specificity of 93%,4 and ultrasound has a sensitivity of 88% and specificity of 96%.5 While CT scan remains a widely accepted modality for diagnosing SBO, ultrasound is more cost effective, well tolerated, does not involve ionizing radiation, and can be done in a timely manner at the patient’s bedside. Ultrasound can also identify transition points as well as distinguish between functional and mechanical obstruction.6 In addition to SBO, ultrasound can be used to diagnose external hernias, intussusception, tumors, superior mesenteric artery (SMA syndrome, foreign bodies, bezoars, and ascariasis.7

  10. Pertussis and Rotavirus Vaccines - Controversies and Solutions.

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    Dash, Nabaneeta; Verma, Sanjay

    2018-01-01

    Pertussis and rotavirus vaccines have been the subject of several controversies over the years. In this paper the authors discuss facts and myths behind these controversies and also suggest solutions to overcome some limitations of these vaccines. The whole-cell pertussis vaccine (wPV) came into disrepute due to the associated adverse reactions, resulting in its replacement by acellular pertussis vaccine (aPV) in industrialized nations in 1990s. Although wPV is known to have more side effects; but they are usually minor. Whole-cell pertussis containing vaccine is being used safely in the National Immunization programme in India from many years. Another controversy erupted during 2009-2010, when there were reports of resurgence of pertussis cases among adolescents and adults, from developed nations. Present literature review raises doubts about long term protection offered by aPV, when compared with wPV. In spite of prevailing controversy, acellular pertussis containing vaccines should be acceptable, if timely delivery of primary and booster doses is ensured; including vaccination of adolescents and pregnant women. Initial rotavirus vaccine was withdrawn from the market because of increased risk of intussusception. Although three new generation rotavirus vaccines are currently available for use in India, but doubts about their efficacy, long term protection and safety still exists. Present literature review found them to be safe and moderately efficacious because of reasonable good cross protection. Even a moderately efficacious vaccine like rotavirus vaccine could significantly improve the outcome if disease burden is high. Therefore, it is being included in National Immunization Programme of India.

  11. Continent Catheterizable Vesicostomy: An Alternative Surgical Modality for Pediatric Patients With Large Bladder Capacity.

    Science.gov (United States)

    Peard, Leslie; Fox, Patrick J; Andrews, William M; Chen, Roger; McCraw, Casey O; Klaassen, Zachary; Neal, Durwood E

    2016-07-01

    To present a modified technique and early outcomes of a continent catheterizable vesicostomy in pediatric patients with either flaccid neurogenic bladder or intractable voiding dysfunction and large capacity bladder. Six patients underwent the procedure from October 2014 to December 2015. A 4-cm Pfannenstiel incision was made, avoiding intraperitoneal dissection. After adequate mobilization, a 2-cm vertical flap at the dome of the bladder was identified and tubularized over a 12Fr catheter with 4-0 vicryl suture. The tubularized flap was then intussuscepted into the bladder with four 4-0 polydioxanone sutures, creating a continent mechanism. The catheterizable channel was then tunneled to the umbilicus, the channel ostomy matured, and the cystotomy closed in two layers. The median patient age was 8 (interquartile range [IQR] 12) years. All patients had urinary dysfunction requiring drainage from etiologies that included Eagle-Barrett syndrome (n = 2), Noonan syndrome (n = 1), Lennox-Gastaut syndrome (n = 1), and Spina bifida (n = 2). Median hospital length of stay was 8 (IQR 3) days. One patient had a superficial wound infection treated with antibiotics, and 1 patient required balloon dilation of the catheterizable channel at 3 months postoperatively, secondary to difficulty self-catheterizing. Five patients were successfully self-catheterizing at last follow-up. Median follow-up was 6 (IQR 5) months and there were no intra- or perioperative complications. Continent catheterizable vesicostomy is a novel technique for urinary drainage in patients with large bladder capacity that spares use of the appendix or ileum. Early results are encouraging, providing a catheterizable channel through the umbilicus without urinary leakage between catheterization. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Managing neonatal bowel obstruction: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Desoky SM

    2018-02-01

    , intestinal malrotation, intussusception, intestinal atresia, meconium ileus, functional immaturity of the colon, Hirschsprung disease, and anorectal malformation. The embryology, epidemiology, clinical presentation, and brief medical and surgical management of each is described. Keywords: neonatal, bowel, intestinal, obstruction

  13. Value of computed tomography in diagnosis of intestinal diseases. CT findings in nontumoral bowel diseases

    Energy Technology Data Exchange (ETDEWEB)

    Fujikawa, Koichi; Yamane, Kosuke; Nakanishi, Tadashi; Miura, Yoshio; Kato, Yoshitaka; Yahata, Noriko; Iwamoto, Toshiyuki; Katayama, Hiroshi; Katsuta, Shizutomo

    1987-03-01

    CT findings of 46 cases with inflammatory and other nontumoral bowel diseases were retrospectively studied. Patients were given 500 to 1000 ml of lukewarm water orally or rectally to distend the intestinal lumen. In all cases water-soluble iodine contrast media was administered intravenously. The CT findings in Crohn's disease included mural thickening, luminal narrowing, bowel wall enhancement, wall rigidity, serration of intestinal border, dilatation of mesenteric vessels, periintestinal blurring (inflamatory reaction of mesentery), fibrofatty proliferation, effusion, abscess and fistula. Many of these findings suggested the transmural nature of the disease and gave diagnostic clues of the disease. In cases with ulcerative colitis, thickening of bowel wall was insignificant and extraintestinal complications were absent. CT appears to play an important role in distinguishing Crohn's disease and ulcerative colitis. Luminal narrowing and mural thickening were also observed in a case with intestinal ischemia, but these mural changes were not accompanied by mesenteric abnormalities to the degree of Crohn's disease. In cases with penetrating peptic ulcer and diverticulitis, CT demonstrated inflammatory reactions of surrounding tissue such as thickening of neighboring fascia, increase in attenuation value of mesenteric fat, effusion and abscess. Even in cases with confusing clinical symptoms, appendicitis was easily diagnosed on CT which showed swelling of appendix and inflammatory changes of surrounding structures. Mechanical obstruction of the intestine could be identified on CT by a notable change of luminal sizes at the site of obstruction. CT appearances of intussusception were distinctive and a soft tissue mass (intussusceptum) and mesenteric fat was seen within a markedly dilated intussuscipiens. CT could also reveal pancreatitis and splenic infarction as the causes of clinically-undiagnosed paralytic ileus. (J.P.N.).

  14. The value of sonography, CT and air enema for detection of complicated Meckel diverticulum in children with nonspecific clinical presentation

    International Nuclear Information System (INIS)

    Daneman, A.; Lobo, E.; Alton, D.J.; Shuckett, B.

    1998-01-01

    Background. Complicated Meckel diverticulum (MD) in children does not always present with painless rectal bleeding and its presentation can then produce a difficult diagnostic dilemma. In this clinical setting, sonography (US), CT or even air enema may be the first modality chosen to evaluate these children rather than the radionuclide Meckel scan (RNMS). Purpose. To assess the value of US, CT and air enema for detection of complicated MD. Materials and methods. Review of clinical, imaging, surgical and pathological findings in 64 children (55 males, 9 females) aged 4 days -14 years (mean = 3.7 years) with MD seen during an 8-year period, 1990-1997. Results. (a) In 33 patients with rectal bleeding, MD was detected on RNMS in 32. Ten of these 32 had other imaging studies, all of which were negative. (b) The other 31 patients, with varied clinical presentations, did not undergo RNMS. In these 31 and the 1 with a negative RNMS, 14 (44 %) had imaging features highly suggestive for the diagnosis of MD on US in all 14, on CT in 1, and on air enema in 3. The radiological spectrum of the inflamed, hemorrhagic MD is illustrated. Conclusion. The inflamed, hemorrhagic and the inverted, intussuscepted MD have a spectrum of features recognizable on US, CT and air enema. Some of these appearances are specific, others are not. Knowledge of and recognition of these features will facilitate detection of complicated MD in larger numbers of children presenting with symptoms other than the classic history of painless rectal bleeding and also in those with normal RNMS. (orig.)

  15. Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding

    Science.gov (United States)

    Mylonaki, M; Fritscher-Ravens, A; Swain, P

    2003-01-01

    Background: The development of wireless capsule endoscopy allows painless imaging of the small intestine. Its clinical use is not yet defined. The aim of this study was to compare the clinical efficacy and technical performance of capsule endoscopy and push enteroscopy in a series of 50 patients with colonoscopy and gastroscopy negative gastrointestinal bleeding. Methods: A wireless capsule endoscope was used containing a CMOS colour video imager, transmitter, and batteries. Approximately 50 000 transmitted images are received by eight abdominal aerials and stored on a portable solid state recorder, which is carried on a belt. Push enteroscopy was performed using a 240 cm Olympus video enteroscope. Results: Studies in 14 healthy volunteers gave information on normal anatomical appearances and preparation. In 50 patients with gastrointestinal bleeding and negative colonoscopy and gastroscopy, push enteroscopy was compared with capsule endoscopy. A bleeding source was discovered in the small intestine in 34 of 50 patients (68%). These included angiodysplasia (16), focal fresh bleeding (eight), apthous ulceration suggestive of Crohn’s disease (three), tumour (two), Meckel’s diverticulum (two), ileal ulcer (one), jejunitis (one), and ulcer due to intussusception (one). One additional intestinal diagnosis was made by enteroscopy. The yield of push enteroscopy in evaluating obscure bleeding was 32% (16/50). The capsule identified significantly more small intestinal bleeding sources than push enteroscopy (pcapsule endoscopy to push enteroscopy (pcapsule endoscopy was superior to push enteroscopy in the diagnosis of recurrent bleeding in patients who had a negative gastroscopy and colonoscopy. It was safe and well tolerated. PMID:12865269

  16. Wireless capsule endoscopy for evaluation of phenotypic expression of small-bowel polyps in patients with Peutz-Jeghers syndrome and in symptomatic first-degree relatives.

    Science.gov (United States)

    Soares, J; Lopes, L; Vilas Boas, G; Pinho, C

    2004-12-01

    Peutz-Jeghers syndrome (PJS) is an inherited gastrointestinal hamartomatous polyposis disorder. Small-bowel intussusception and bleeding are the most common complications, and malignancy may also occur. Survey of the gastrointestinal tract, particularly of the small bowel, is difficult and current recommendations for management syndrome are ambiguous. We evaluated the feasibility of capsule endoscopy for identifying phenotypic expression of small-bowel polyps in patients with full-blown PJS and a previous diagnosis of gastrointestinal polyposis, and in symptomatic kindred of PJS patients with no previous diagnosis of gastrointestinal polyposis. Two groups were studied: group A consisted of 14 patients with gastrointestinal polyposis, eight of whom had undergone previous small-intestine surgery; group B consisted of six symptomatic first-degree relatives of PJS patients; these patients had previous negative gastrointestinal endoscopic examinations. Numerous polyps were detected in all patients in group A. Most polyps were sessile, but the larger polyps tended to be pedunculated. Polyp density was highest in the jejunum (greater than in the ileum and duodenum). Seven patients had at least one large polyp (> 11 mm) and five of these patients subsequently underwent enteroscopy, which revealed that capsule endoscopy had correctly identified all the patients with large polyps, but had missed 20 % of the total number of large polyps in these patients. No polyps were detected by capsule endoscopy in group B patients, despite the excellent visualization of the small intestine. In all patients, the capsules were expelled within 24 hours, without complications, and the procedure was well tolerated. Capsule endoscopy is an effective and well-tolerated method for evaluating small-bowel pathology in patients with PJS.

  17. Efficacy, safety and immunogenicity of a human rotavirus vaccine (RIX4414) in Hong Kong children up to three years of age: a randomized, controlled trial.

    Science.gov (United States)

    Lau, Yu-Lung; Nelson, E Anthony S; Poon, Kin-Hung; Chan, Paul K S; Chiu, Susan; Sung, Rita; Leung, Chi Wai; Ng, Daniel; Ma, Yee Man; Chan, Desmond; Lee, Tsz Leung; Tang, Joyce; Kwan, Yat Wah; Ip, Patricia; Ho, Marco; Fung, Lai-Wah Eva; Tang, Haiwen; Suryakiran, P V; Han, Htay Htay; Bock, Hans

    2013-04-26

    A phase III, double-blind, randomized, controlled trial was conducted in Hong Kong to evaluate the efficacy, safety and immunogenicity of a human rotavirus vaccine, RIX4414 (Rotarix) against severe rotavirus gastroenteritis in children up to three years of age. Healthy infants aged 6-12 weeks were enrolled between 08-December-2003 and 31-August-2005 and received two oral doses of either RIX4414 vaccine (N=1513) or placebo (N=1512) given 2 months apart. Vaccine efficacy was assessed from two weeks post-Dose 2 until the children were two and three years of age. Anti-rotavirus IgA seroconversion rate was calculated pre-vaccination and 1-2 months post-Dose 2 using ELISA (cut-off=20 U/mL) for 100 infants. Safety was assessed until the children were two years of age; serious adverse events (SAEs) were recorded throughout the study period. In children aged two and three years of life, vaccine efficacy against severe rotavirus gastroenteritis was 95.6% (95% CI: 73.1%-99.9%) and 96.1% (95% CI: 76.5%-99.9%), respectively. The seroconversion rate 1-2 months after the second dose of RIX4414 was 97.5% (95% CI: 86.8%-99.9%). At least one SAE was recorded in 439 and 477 infants who were administered RIX4414 and placebo, respectively (p-value=0.130). Six intussusception cases were reported (RIX4414=4; placebo=2) and none was assessed to be vaccine-related. RIX4414 was efficacious, immunogenic and safe in the prevention of rotavirus gastroenteritis for at least two years post-vaccination in Hong Kong children. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Inflammatory fibroid polyp of the gastrointestinal tract: 10 years of experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

    Science.gov (United States)

    Romano-Munive, A F; Barreto-Zuñiga, R; Rumoroso-García, J A; Ramos-Martínez, P

    2016-01-01

    Inflammatory fibroid polyp (lFP) is a rare, benign, and solitary neoplasm predominantly located in the gastric antrum and small bowel. Its clinical symptoms are heterogeneous and essentially depend on the location and size of the tumor. Definitive diagnosis is made through histopathology and this pathology has excellent long-term prognosis. To identify the cases of IFP seen at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán over a 10-year period. A retrospective, cross-sectional, descriptive, and observational study was conducted that included patients with histopathologic diagnosis of IFP within the time frame of January 2001 and December 2011. Six cases were found and 5/6 (83.3%) of them were women. The median age was 41 years (minimum-maximum range of 19-56 years). The most frequent symptoms were weight loss (n=3), fever (n=2), nausea (n=2), and vomiting (n=2). Three patients presented with iron deficiency anemia and 2 cases with intussusception. The IFPs were located at the following sites: esophagus (n=1), stomach (n=2), small bowel (n=2), and colon (n=1). Treatment was surgical in 5/6 (83.3%) of the patients. IFPs are extremely rare in our population. They usually present with weight loss and iron deficiency anemia and are more frequently located in the stomach and small bowel. This is the largest reported IFP case series in a Mexican population. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  19. CT enteroclysis in the diagnosis of obscure gastrointestinal bleeding: initial results

    International Nuclear Information System (INIS)

    Jain, T.P.; Gulati, M.S.; Makharia, G.K.; Bandhu, S.; Garg, P.K.

    2007-01-01

    Aim: To evaluate the usefulness of computed tomography (CT) enteroclysis in patients with obscure gastrointestinal (GI) bleeding. Materials and methods: In a prospective study, CT enteroclysis was performed in 21 patients (median age 50 years; range 13-71 years) with obscure GI bleeding in which the source of the bleeding could not be detected despite the patient having undergone both upper GI endoscopic and colonoscopic examinations. The entire abdomen and pelvis was examined in the arterial and venous phases using multisection CT after distending the small intestine with 2 l of 0.5% methylcellulose as a neutral enteral contrast medium and the administration of 150 ml intravenous contrast medium. Results: Adequate distension of the small intestine was achieved in 20 of the 21 (95.2%) patients. Potential causes of GI bleeding were identified in 10 of the 21 (47.6%) patients using CT enteroclysis. The cause of the bleeding could be detected nine of 14 (64.3%) patients with overt, obscure GI bleeding. However, for patients with occult, obscure GI bleeding, the cause of the bleeding was identified in only one of the seven (14.3%) patients. The lesions identified by CT enteroclysis included small bowel tumours (n = 2), small bowel intussusceptions (n = 2), intestinal tuberculosis (n = 2), and vascular lesions (n = 3). All vascular lesions were seen equally well in both the arterial and venous phases. Conclusions: The success rate in detection of the cause of bleeding using CT enteroclysis was 47.6% in patients with obscure GI bleeding. The diagnostic yield was higher in patients with overt, obscure GI bleeding than in those with occult obscure GI bleeding

  20. Deaths following vaccination: What does the evidence show?

    Science.gov (United States)

    Miller, Elaine R; Moro, Pedro L; Cano, Maria; Shimabukuro, Tom T

    2015-06-26

    Vaccines are rigorously tested and monitored and are among the safest medical products we use. Millions of vaccinations are given to children and adults in the United States each year. Serious adverse reactions are rare. However, because of the high volume of use, coincidental adverse events including deaths, that are temporally associated with vaccination, do occur. When death occurs shortly following vaccination, loved ones and others might naturally question whether it was related to vaccination. A large body of evidence supports the safety of vaccines, and multiple studies and scientific reviews have found no association between vaccination and deaths except in rare cases. During the US multi-state measles outbreak of 2014-2015, unsubstantiated claims of deaths caused by measles, mumps, and rubella (MMR) vaccine began circulating on the Internet, prompting responses by public health officials to address common misinterpretations and misuses of vaccine safety surveillance data, particularly around spontaneous reports submitted to the US Vaccine Adverse Event Reporting System (VAERS). We summarize epidemiologic data on deaths following vaccination, including examples where reasonable scientific evidence exists to support that vaccination caused or contributed to deaths. Rare cases where a known or plausible theoretical risk of death following vaccination exists include anaphylaxis, vaccine-strain systemic infection after administration of live vaccines to severely immunocompromised persons, intussusception after rotavirus vaccine, Guillain-Barré syndrome after inactivated influenza vaccine, fall-related injuries associated with syncope after vaccination, yellow fever vaccine-associated viscerotropic disease or associated neurologic disease, serious complications from smallpox vaccine including eczema vaccinatum, progressive vaccinia, postvaccinal encephalitis, myocarditis, and dilated cardiomyopathy, and vaccine-associated paralytic poliomyelitis from oral