We present a rare case of adult intussusception (AI) due to a small bowel fibroma, which presented as recurrent subacute symptoms. To our knowledge, this is the first reported case managed by intraluminal excision of the causative lesion by enterotomy as opposed to bowel resection. A 34-year-old woman presented with recurrent colicky abdominal pain. Computed tomography demonstrated ileoileal intussusception, with magnetic resonance imaging revealing a 2.3-cm intraluminal lesion acting as a lead point. The patient underwent laparotomy and the intussusception was reduced. Palpation of the lesion demonstrated a pedunculated polyp without suspicious features; so the lesion was resected via enterotomy as opposed to small bowel resection. Histopathological analysis diagnosed a benign fibroma. AI is a rare but important entity, with potentially devastating consequences for delayed diagnosis. The majority of lesions causing AI are benign and may be amenable to intraluminal resection via enterotomy, thus avoiding unnecessary bowel resection.
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http://dx.doi.org/10.1093/jscr/rjab253 | DOI Listing |
J Surg Case Rep
January 2025
Department of Colorectal Surgery, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, Sydney, New South Wales 2076, Australia.
An 84-year-old lady presented with 1 day history of sudden onset generalized abdominal pain, fevers, and peritonism. Computed tomography was suggestive of a mid-small bowel perforation associated with a distal ovoid soft tissue density structure without pneumobilia. An urgent laparotomy demonstrated two areas of jejunal diverticula necrosis and perforation associated with a 3 cm luminal mass in the proximal ileum, and proximal small bowel dilatation.
View Article and Find Full Text PDFCureus
December 2024
Gastroenterology and Hepatology, Washington University in St. Louis, St. Louis, USA.
Introduction Colorectal cancer (CRC) represents a major global health burden, significantly impacting mortality rates and healthcare systems worldwide. CRC screening through colonoscopy enables early detection and removal of precancerous polyps. While standard polypectomy suffices for small polyps, larger ones require endoscopic mucosal resection (EMR).
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Angiology and Vascular Surgery, Unidade Local de Saúde de São João; Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal.
A 44 year-old previously healthy woman presented a persistent epigastric pain. Computed tomography revealed a saccular aneurysm with a diameter of 25x20 mm in the first jejunal artery and also a stenosis in the celiac trunk associated with median arcuate ligament syndrome, turning the hepatic perfusion dependent of the gastroduodenal artery flow. Through a midline laparotomy, celiac axis was exposed, and median arcuate ligament released for median arcuate ligament syndrome treatment.
View Article and Find Full Text PDFInt J Colorectal Dis
January 2025
Hereditary Digestive Tract Tumors Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Giacomo Venezian 1, 20133, Milan, Italy.
Purpose: In this study, we investigated the progression of high-grade dysplasia (HGD)/CRC in patients with hereditary colorectal cancer syndromes (HCSS) and concomitant inflammatory bowel diseases (IBDs).
Methods: We described the natural history of a series of patients with confirmed diagnosis of hereditary colorectal cancer syndromes (HCCSs) and concomitant IBDs who were referred to the Hereditary Digestive Tumors Registry at the Fondazione IRCCS Istituto Nazionale dei Tumori of Milan.
Results: Between January 1989 and April 2024, among 450 patients with APC-associated polyposis and 1050 patients with Lynch syndrome (LS), we identified six patients with IBDs (five with UC, one with ileal penetrating CD) and concomitant HCCSs (five with LS, one with APC-associated polyposis).
J Clin Med
January 2025
Haya Al-Habeeb Gastroenterology Center, Mubarak Alkabeer Hospital, Jabriyah 13110, Kuwait.
Colorectal cancer (CRC) is the second leading cause of cancer death in Kuwait. The effectiveness of colonoscopy in preventing CRC is dependent on a high adenoma detection rate (ADR). Computer-aided detection can identify (CADe) and characterize polyps in real time and differentiate benign from neoplastic polyps, but its role remains unclear in screening colonoscopy.
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