BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated b...BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated by appendiceal mucinous tumor,supplemented by a review of 10 previously reported cases to distill diagnostic and therapeutic insights.CASE SUMMARY A 74-year-old male patient presented with abdominal pain.Abdominal contrastenhanced computed tomography(CECT)initially suggested a colonic tumor with intussusception.Colonoscopy identified a mass in the colon 60 cm from the anus.Intraoperative exploration confirmed CAI secondary to an appendiceal neoplasm.The patient underwent laparoscopic right hemicolectomy with regional lymphadenectomy under general anesthesia.Postoperative recovery was uneventful,and the patient was discharged 9 days post-surgery.Twelve-month follow-up revealed no evidence of recurrence or metastasis.CONCLUSION Plain abdominal computed tomography may underestimate the presence of CAI and appendiceal mucinous tumor,whereas CECT significantly improves diagnostic accuracy.Preoperative suspicion of appendiceal malignancy should be entertained in cases of CAI.In the absence of definitive biopsy results,intraoperative frozen section analysis is recommended to guide radical resection.展开更多
Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to lifethreatening com...Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to lifethreatening complications if left untreated or could delay chemotherapy if inappropriate surgical management is used. We report a 31-year-old man diagnosed with human immunodeficiency virus who was being treated with antiretroviral therapy. He presented with nausea, vomiting, poor appetite, and intermittent, cramping abdominal pain for over 1 wk. Abdominal computed tomography revealed a well-defined homogeneous mass in the mesenteric root region, together with a long segmental wall thickening in the ileum with ileocolic-type intussusception, which was suspected to be caused by a lymphoma. The intussusception was successfully laparoscopically reduced, and the tumor involvement of the appendix was confirmedby appendectomy with intraoperative frozen section. Systemic chemotherapy was immediately initiated after surgery without the need for bowel resection.展开更多
BACKGROUND Intussusception can be managed by pneumatic reduction,ultrasound-guided hydrostatic reduction,open or laparoscopic surgery,but laparoscopy in such cases remains controversial.AIM To explore the clinical cha...BACKGROUND Intussusception can be managed by pneumatic reduction,ultrasound-guided hydrostatic reduction,open or laparoscopic surgery,but laparoscopy in such cases remains controversial.AIM To explore the clinical characteristics,effectiveness,and complications of surgical reduction for intussusception using laparoscopy in children.METHODS This study was a retrospective case series of pediatric patients with intussusception who underwent surgical reduction by laparoscopy from May 2011 to April 2016 at Taizhou Hospital of Zhejiang Province.Clinical characteristics(operation time,intraoperative blood loss,conversion rate of laparotomy,reasons for conversion,postoperative hospital stay,and adverse events)were described.RESULTS The 65 patients included 45 boys and 20 girls.The average age was 2.3 years(27.5±24.5 mo).Of the 65 patients,61 underwent surgical reduction by laparoscopy after a failed enema reduction of intussusception,and four underwent the procedure directly.All patients were treated successfully and 57(87.7%)patients underwent successful laparoscopic surgery,two of which had a spontaneous reduction.Among the remaining cases,one was converted to open surgery via right upper quadrant incision,and seven required enlarged umbilical incisions.Intestinal resection was performed in 5 patients because of abnormal bowel lesions.There were no complications(intestinal perforations,wound infections,or intestinal adhesions)during the follow-up of 3 years to 8 years.Two patients experienced a recurrence of intussusception;one was resolved with pneumatic reduction,and the other underwent a second laparoscopic surgery.CONCLUSION Laparoscopic approach for pediatric intussusception is feasible and safe.Bowel resection if required can be performed by extending umbilical incision without the conventional laparotomy.展开更多
BACKGROUND Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum,which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intes...BACKGROUND Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum,which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intestinal obstruction.The rarity of this case presentation is the co-occurrence of appendiceal intussusception and cecal adenocarcinoma,a combination that to our knowledge has not previously been reported in the medical literature.This case provides new insights into the complexities of diagnosing and managing overlapping pathologies.CASE SUMMARY A 25-year-old woman presented with persistent periumbilical pain and bloody stools.An initial biopsy showed cecal cancer;however,subsequent colonoscopy and computed tomography findings raised the suspicion of appendiceal intussus-ception,which was later confirmed postoperatively.This unique case was charac-terized by a combination of intussusception and adenocarcinoma of the cecum.The intervention included a laparoscopic right hemicolectomy,which led to the histopathological diagnosis of mucinous adenocarcinoma with appendiceal intussusception.The patient recovered well postoperatively and was advised to initiate adjuvant chemotherapy.This case highlights not only the importance of considering appendiceal intussusception in the differential diagnosis,but also the possibility of appendicitis and the atypical presentation of neoplastic lesions.CONCLUSIONS Physicians should consider the possibility of appendiceal intussusception in cases of atypical appendicitis,particularly when associated with neoplastic presentation.展开更多
Percutaneous endoscopic gastrostomy (PEG) tube complications can be serious or life threatening. Retrograde intussusception is a very rare complication of PEG tubes with only 9 cases reported in the literature. We des...Percutaneous endoscopic gastrostomy (PEG) tube complications can be serious or life threatening. Retrograde intussusception is a very rare complication of PEG tubes with only 9 cases reported in the literature. We describe a case of retrograde intussusception, associated with the use of a Foley catheter as a replacement gastrostomy tube, presenting with upper gastrointestinal bleeding. To our knowledge, this is the first reported case of PEG-related retrograde intussusception successfully managed in a non-surgical manner. Retrograde intussusception likely occurred due to migration of the replacement tube with resultant securing and invagination of the proximal jejunum when the gastrostomy tube was anchored to the abdominal wall.展开更多
BACKGROUND Intussusception is the invagination of a segment of the bowel into an adjacent segment.It is the most common cause of intestinal obstruction in children,but in adults,it is rare,accounting for 1%of all inte...BACKGROUND Intussusception is the invagination of a segment of the bowel into an adjacent segment.It is the most common cause of intestinal obstruction in children,but in adults,it is rare,accounting for 1%of all intestinal obstructions and 5%of all intussusceptions,with malignancy being the most common cause.In the past,it was typically diagnosed intraoperatively.However,with the availability of computed tomography for abdominal imaging,recognizing the condition's signs has become crucial.Surgical intervention is essential for managing neoplastic cases and their complications.CASE SUMMARY A 45-year-old female presented with severe abdominal pain encompassing her entire abdomen,abdominal distension,vomiting,and persistent constipation.Over the past two months,she has also experienced considerable weight loss.After an initial history review,examination,and imaging investigations,the patient was diagnosed with ileo cecal intussusception resulting from a colo rectal mass located in the cecum and ascending colon.This condition was surgically managed through an extended right hemi colectomy.CONCLUSION Intussusception is uncommon in adults,but it should be considered in patients with intestinal obstruction.Surgical intervention is essential.展开更多
[Objectives] The aim was to analyze the effect of Salvia miltiorrhiza injection combined with laparoscopic reduction on the degree of appendix injury in intussusception.[Methods]Seventy-four children with intussuscept...[Objectives] The aim was to analyze the effect of Salvia miltiorrhiza injection combined with laparoscopic reduction on the degree of appendix injury in intussusception.[Methods]Seventy-four children with intussusception who were treated in the Xuchang Municipal Hospital from August 2014 to August 2017 were randomly and evenly divided into two groups,control group and treatment group.The children in the control group were treated by laparoscopic reduction,and those in the treatment group were treated with S.miltiorrhiza injection combined with laparoscopic reduction.The clinical effect on intussusception in the children was compared between the two groups.[Results] Before treatment,no significant difference was founding serum NO level between the control and treatment groups(P > 0.05).On Day 1,3 and 5 of treatment,the serum NO levels of the treatment group[(74.16 ± 6.81),(61.98 ± 4.77) and(54.76 ± 4.36) μmol/L] were significantly lower than those of the control group[(89.67 ± 6.34),(84.75 ± 5.21) and(71.95 ± 4.58) μmol/L](P < 0.05).After treatment,the TNF-α and IL-6 levels of the treatment group[(184.32 ± 10.67) and(332.16 ± 34.17) pg/m L] were significantly lower than those of the control group[(268.26 ± 12.74) and(438.23 ± 35.26) pg/m L](P < 0.05);and the Chiu score of the treatment group(2.34 ± 1.12) was also significantly lower than that of the control group(4.85 ± 1.67)(P < 0.05).[Conclusions]For children with intussusception,S.miltiorrhiza injection combined with laparoscopic reduction is effective in reducing serum NO level and reducing the degree of appendix injury,which is worthy of clinical application.展开更多
Intussusception of the appendix is a rare condition. Most cases are diagnosed during operation of the patients suspected to have appendicitis. In this report we present a seventy one year-old man with a history of per...Intussusception of the appendix is a rare condition. Most cases are diagnosed during operation of the patients suspected to have appendicitis. In this report we present a seventy one year-old man with a history of periumbilical intermittent abdominal pain for several months. None of the paraclinical tests were useful for determining the diagnosis. Colonoscopy performed during the last episode of abdominal pain revealed the prolapsed appendix in the cecum and the patient was sent to the operating room. Macroscopic appearance of the appendix was normal and microscopic examination revealed follicular hyperplasia and acute focal appendicitis. Appendiceal intussusception should be considered in differential diagnosis of intermittent abdominal pain and colonoscopic diagnosis could be very important to avoid dangerous or unnecessary decision making.展开更多
To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old...To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.展开更多
Objective:To introduce high-frequency ultrasound diagnostic technology to cooperate with diagnosis and treatment for patients with intussusception,and to observe its clinical application effect.Methods:The study took ...Objective:To introduce high-frequency ultrasound diagnostic technology to cooperate with diagnosis and treatment for patients with intussusception,and to observe its clinical application effect.Methods:The study took patients with intussusception as the object of observation,with a total of 52 cases participating,all of which were clinically admitted from December 2022 to December 2023.After enrollment,the patients underwent high-frequency ultrasound detection in sequence,recording the ultrasound imaging characteristics,and referring to the results of surgical or leaky saline enema reset to confirm the diagnosis(the gold standard)to assess the diagnostic efficacy of high-frequency ultrasound technology.Results:Comparing the confirmed diagnostic results of surgery or leaking saline enema restoration,the detection rate of high-frequency ultrasound technology was 98.07%(P>0.05).Among the 52 patients treated with hydropneumatic enema restoration with the cooperation of high-frequency ultrasound monitoring,39 patients were successfully reset in the first treatment(75.00%),while 9 patients were successfully reset(17.30%)after multiple treatments(≥2 times);the remaining 4 patients were unsuccessful and then converted to surgical treatment,and all of them were successfully treated and cured.Conclusion:For the diagnosis of intussusception,high-frequency color Doppler ultrasound has the advantages of high accuracy and simple operation,which provides a scientific and accurate reference basis for the clinical diagnosis and treatment of patients.展开更多
文摘BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated by appendiceal mucinous tumor,supplemented by a review of 10 previously reported cases to distill diagnostic and therapeutic insights.CASE SUMMARY A 74-year-old male patient presented with abdominal pain.Abdominal contrastenhanced computed tomography(CECT)initially suggested a colonic tumor with intussusception.Colonoscopy identified a mass in the colon 60 cm from the anus.Intraoperative exploration confirmed CAI secondary to an appendiceal neoplasm.The patient underwent laparoscopic right hemicolectomy with regional lymphadenectomy under general anesthesia.Postoperative recovery was uneventful,and the patient was discharged 9 days post-surgery.Twelve-month follow-up revealed no evidence of recurrence or metastasis.CONCLUSION Plain abdominal computed tomography may underestimate the presence of CAI and appendiceal mucinous tumor,whereas CECT significantly improves diagnostic accuracy.Preoperative suspicion of appendiceal malignancy should be entertained in cases of CAI.In the absence of definitive biopsy results,intraoperative frozen section analysis is recommended to guide radical resection.
基金Supported by National Defense Medical Center,Tri-Service General Hospital,Neihu 114,Taipei,Taiwan
文摘Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to lifethreatening complications if left untreated or could delay chemotherapy if inappropriate surgical management is used. We report a 31-year-old man diagnosed with human immunodeficiency virus who was being treated with antiretroviral therapy. He presented with nausea, vomiting, poor appetite, and intermittent, cramping abdominal pain for over 1 wk. Abdominal computed tomography revealed a well-defined homogeneous mass in the mesenteric root region, together with a long segmental wall thickening in the ileum with ileocolic-type intussusception, which was suspected to be caused by a lymphoma. The intussusception was successfully laparoscopically reduced, and the tumor involvement of the appendix was confirmedby appendectomy with intraoperative frozen section. Systemic chemotherapy was immediately initiated after surgery without the need for bowel resection.
文摘BACKGROUND Intussusception can be managed by pneumatic reduction,ultrasound-guided hydrostatic reduction,open or laparoscopic surgery,but laparoscopy in such cases remains controversial.AIM To explore the clinical characteristics,effectiveness,and complications of surgical reduction for intussusception using laparoscopy in children.METHODS This study was a retrospective case series of pediatric patients with intussusception who underwent surgical reduction by laparoscopy from May 2011 to April 2016 at Taizhou Hospital of Zhejiang Province.Clinical characteristics(operation time,intraoperative blood loss,conversion rate of laparotomy,reasons for conversion,postoperative hospital stay,and adverse events)were described.RESULTS The 65 patients included 45 boys and 20 girls.The average age was 2.3 years(27.5±24.5 mo).Of the 65 patients,61 underwent surgical reduction by laparoscopy after a failed enema reduction of intussusception,and four underwent the procedure directly.All patients were treated successfully and 57(87.7%)patients underwent successful laparoscopic surgery,two of which had a spontaneous reduction.Among the remaining cases,one was converted to open surgery via right upper quadrant incision,and seven required enlarged umbilical incisions.Intestinal resection was performed in 5 patients because of abnormal bowel lesions.There were no complications(intestinal perforations,wound infections,or intestinal adhesions)during the follow-up of 3 years to 8 years.Two patients experienced a recurrence of intussusception;one was resolved with pneumatic reduction,and the other underwent a second laparoscopic surgery.CONCLUSION Laparoscopic approach for pediatric intussusception is feasible and safe.Bowel resection if required can be performed by extending umbilical incision without the conventional laparotomy.
基金the National Natural Science Foundation of China,No.82060440.
文摘BACKGROUND Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum,which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intestinal obstruction.The rarity of this case presentation is the co-occurrence of appendiceal intussusception and cecal adenocarcinoma,a combination that to our knowledge has not previously been reported in the medical literature.This case provides new insights into the complexities of diagnosing and managing overlapping pathologies.CASE SUMMARY A 25-year-old woman presented with persistent periumbilical pain and bloody stools.An initial biopsy showed cecal cancer;however,subsequent colonoscopy and computed tomography findings raised the suspicion of appendiceal intussus-ception,which was later confirmed postoperatively.This unique case was charac-terized by a combination of intussusception and adenocarcinoma of the cecum.The intervention included a laparoscopic right hemicolectomy,which led to the histopathological diagnosis of mucinous adenocarcinoma with appendiceal intussusception.The patient recovered well postoperatively and was advised to initiate adjuvant chemotherapy.This case highlights not only the importance of considering appendiceal intussusception in the differential diagnosis,but also the possibility of appendicitis and the atypical presentation of neoplastic lesions.CONCLUSIONS Physicians should consider the possibility of appendiceal intussusception in cases of atypical appendicitis,particularly when associated with neoplastic presentation.
文摘Percutaneous endoscopic gastrostomy (PEG) tube complications can be serious or life threatening. Retrograde intussusception is a very rare complication of PEG tubes with only 9 cases reported in the literature. We describe a case of retrograde intussusception, associated with the use of a Foley catheter as a replacement gastrostomy tube, presenting with upper gastrointestinal bleeding. To our knowledge, this is the first reported case of PEG-related retrograde intussusception successfully managed in a non-surgical manner. Retrograde intussusception likely occurred due to migration of the replacement tube with resultant securing and invagination of the proximal jejunum when the gastrostomy tube was anchored to the abdominal wall.
文摘BACKGROUND Intussusception is the invagination of a segment of the bowel into an adjacent segment.It is the most common cause of intestinal obstruction in children,but in adults,it is rare,accounting for 1%of all intestinal obstructions and 5%of all intussusceptions,with malignancy being the most common cause.In the past,it was typically diagnosed intraoperatively.However,with the availability of computed tomography for abdominal imaging,recognizing the condition's signs has become crucial.Surgical intervention is essential for managing neoplastic cases and their complications.CASE SUMMARY A 45-year-old female presented with severe abdominal pain encompassing her entire abdomen,abdominal distension,vomiting,and persistent constipation.Over the past two months,she has also experienced considerable weight loss.After an initial history review,examination,and imaging investigations,the patient was diagnosed with ileo cecal intussusception resulting from a colo rectal mass located in the cecum and ascending colon.This condition was surgically managed through an extended right hemi colectomy.CONCLUSION Intussusception is uncommon in adults,but it should be considered in patients with intestinal obstruction.Surgical intervention is essential.
基金Supported by Medical Science and Technology Project of Henan Province(201503137)
文摘[Objectives] The aim was to analyze the effect of Salvia miltiorrhiza injection combined with laparoscopic reduction on the degree of appendix injury in intussusception.[Methods]Seventy-four children with intussusception who were treated in the Xuchang Municipal Hospital from August 2014 to August 2017 were randomly and evenly divided into two groups,control group and treatment group.The children in the control group were treated by laparoscopic reduction,and those in the treatment group were treated with S.miltiorrhiza injection combined with laparoscopic reduction.The clinical effect on intussusception in the children was compared between the two groups.[Results] Before treatment,no significant difference was founding serum NO level between the control and treatment groups(P > 0.05).On Day 1,3 and 5 of treatment,the serum NO levels of the treatment group[(74.16 ± 6.81),(61.98 ± 4.77) and(54.76 ± 4.36) μmol/L] were significantly lower than those of the control group[(89.67 ± 6.34),(84.75 ± 5.21) and(71.95 ± 4.58) μmol/L](P < 0.05).After treatment,the TNF-α and IL-6 levels of the treatment group[(184.32 ± 10.67) and(332.16 ± 34.17) pg/m L] were significantly lower than those of the control group[(268.26 ± 12.74) and(438.23 ± 35.26) pg/m L](P < 0.05);and the Chiu score of the treatment group(2.34 ± 1.12) was also significantly lower than that of the control group(4.85 ± 1.67)(P < 0.05).[Conclusions]For children with intussusception,S.miltiorrhiza injection combined with laparoscopic reduction is effective in reducing serum NO level and reducing the degree of appendix injury,which is worthy of clinical application.
文摘Intussusception of the appendix is a rare condition. Most cases are diagnosed during operation of the patients suspected to have appendicitis. In this report we present a seventy one year-old man with a history of periumbilical intermittent abdominal pain for several months. None of the paraclinical tests were useful for determining the diagnosis. Colonoscopy performed during the last episode of abdominal pain revealed the prolapsed appendix in the cecum and the patient was sent to the operating room. Macroscopic appearance of the appendix was normal and microscopic examination revealed follicular hyperplasia and acute focal appendicitis. Appendiceal intussusception should be considered in differential diagnosis of intermittent abdominal pain and colonoscopic diagnosis could be very important to avoid dangerous or unnecessary decision making.
文摘To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.
文摘Objective:To introduce high-frequency ultrasound diagnostic technology to cooperate with diagnosis and treatment for patients with intussusception,and to observe its clinical application effect.Methods:The study took patients with intussusception as the object of observation,with a total of 52 cases participating,all of which were clinically admitted from December 2022 to December 2023.After enrollment,the patients underwent high-frequency ultrasound detection in sequence,recording the ultrasound imaging characteristics,and referring to the results of surgical or leaky saline enema reset to confirm the diagnosis(the gold standard)to assess the diagnostic efficacy of high-frequency ultrasound technology.Results:Comparing the confirmed diagnostic results of surgery or leaking saline enema restoration,the detection rate of high-frequency ultrasound technology was 98.07%(P>0.05).Among the 52 patients treated with hydropneumatic enema restoration with the cooperation of high-frequency ultrasound monitoring,39 patients were successfully reset in the first treatment(75.00%),while 9 patients were successfully reset(17.30%)after multiple treatments(≥2 times);the remaining 4 patients were unsuccessful and then converted to surgical treatment,and all of them were successfully treated and cured.Conclusion:For the diagnosis of intussusception,high-frequency color Doppler ultrasound has the advantages of high accuracy and simple operation,which provides a scientific and accurate reference basis for the clinical diagnosis and treatment of patients.
