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3.
Arch. argent. pediatr ; 118(3): e338-e341, jun. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1117378

ABSTRACT

La invaginación intestinal ocurre cuando un segmento proximal de intestino se repliega dentro de la luz de un segmento distal adyacente y provoca obstrucción intestinal. Es una causa común de abdomen agudo en los dos primeros años de la vida, pero raro en niños mayores. Un varón de 16 años, con diagnóstico de fibrosis quística, se presentó con un cuadro compatible con síndrome de oclusión intestinal distal. Consultó a la clínica con dolor abdominal y una masa palpable en el hipocondrio derecho. Se realizó ecografía abdominal y tomografía de abdomen contrastada, que demostraron invaginación íleo-colónica con signos de isquemia intestinal, necrosis y neumatosis de la pared intestinal. Fue intervenido: se realizó resección del íleon terminal y hemicolon derecho, y se detectó una tumoración en ciego. La invaginación íleo-colónica es una causa rara de abdomen agudo en pacientes adolescentes con fibrosis quística y puede estar asociada a una causa orgánica subyacente.


Intestinal intussusception occurs when a proximal segment of the intestine telescopes into the lumen of an adjacent distal segment, causing intestinal obstruction. It is a common cause of acute abdomen in the first two years of life, but rare in older children. A 16-year-old male with a diagnosis of cystic fibrosis presented with symptoms compatible with distal intestinal occlusion syndrome. He came at the cystic fibrosis clinic with a 5-day evolution of abdominal pain and a palpable mass in the right hypochondrium. Abdominal ultrasound and abdominal contrasted tomography were performed demonstrating ileo-colonic invagination with signs of intestinal ischemia, necrosis and pneumatosis of the intestinal wall. He underwent surgery with resection of the terminal ileum and right hemicolon, ana tumor in the caecum was found. This is a rare cause of acute abdomen in young patients with cystic fibrosis and may be associated with an underlying organic cause.


Subject(s)
Humans , Male , Adolescent , Cystic Fibrosis , Intussusception/diagnostic imaging , Abdominal Pain , Ileum/surgery , Intestinal Obstruction , Intussusception/surgery
4.
Arch. argent. pediatr ; 118(2): e188-e190, abr. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1100470

ABSTRACT

La invaginación intestinal es la causa más frecuente de obstrucción intestinal entre los 6 y los 36 meses de edad. La mayoría son idiopáticas. Se ha descrito la asociación entre la enfermedad celíaca y la invaginación intestinal en la población pediátrica. Se presenta el caso de un varón de 23 meses ingresado por estancamiento ponderal en cuyo estudio ecográfico se observaron invaginaciones íleo-ileales asintomáticas repetidas.


Intestinal intussusception is the most frequent cause of intestinal obstruction between 6 and 36 months of age, the majority being idiopathic. The association between celiac disease and intestinal intussusception in the pediatric population has been described. We present the case of a 23-month-old male admitted due to a failure to thrive. In his ultrasound study recurrent asymptomatic ileo-ileal invaginations were found


Subject(s)
Humans , Male , Infant , Celiac Disease/diagnosis , Intussusception/diagnostic imaging , Celiac Disease/diet therapy , Failure to Thrive , Diet, Gluten-Free , Intussusception/diet therapy
5.
Rev. argent. coloproctología ; 30(4): 114-118, dic. 2019. ilus, graf
Article in Spanish | LILACS | ID: biblio-1096800

ABSTRACT

Los lipomas del colon ocupan el tercer lugar en frecuencia de aparición de tumores benignos. Estos tumores están formados por tejido adiposo bien diferenciado con un estroma fibroso. La gran mayoría de estos lipomas es asintomática, algunos en raras ocasiones presentan complicaciones de urgencia. El fin de esta publicación es presentar un caso de obstrucción de colon por lipoma. (AU)


Benign colonic lesions are infrequent and account for a low percentage of all colonic tumors. Among the benign tumors, lipomas are third in frequency. They are composed of mature adipose tissue with fibrous stroma. Most of them are asymptomatic but in rare instances, they may present as surgical emergencies. We present one case of colonic obstruction caused by lipomas. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Colonic Neoplasms/complications , Intussusception/etiology , Intussusception/diagnostic imaging , Lipoma/complications , Endoscopy, Gastrointestinal/methods , Colonoscopy/methods , Laparoscopy/methods , Colonic Neoplasms/surgery , Intussusception/surgery , Lipoma/surgery
6.
Rev. chil. cir ; 69(3): 259-263, jun. 2017. ilus
Article in Spanish | LILACS | ID: biblio-844370

ABSTRACT

Introducción: Los pólipos gástricos adenomatosos son poco frecuentes y generalmente se encuentran en el examen endoscópico de rutina. La intususcepción gastroduodenal es una complicación poco frecuente de los pólipos gástricos y ha sido raramente descrita como una causa de pancreatitis aguda. Caso clínico: Presentamos el caso de un varón de 68 años el cual ingresa de urgencia con dolor abdominal, náuseas y vómitos catalogados en un inicio como pancreatitis aguda de etiología biliar; incidentalmente se descubre un pólipo gástrico pediculado intususceptado a duodeno como causa de la pancreatitis aguda. Se realizó tratamiento endoscópico de urgencia y tratamiento definitivo con cirugía abierta.


Introduction: Adenomatous gastric polyps are uncommon and are usually found in the routine endoscopic examination. Gastroduodenal intussusception is a rare complication of those gastric polyps and has rarely been described as a cause of acute pancreatitis. Case report: We present the case of a 68 year old man who admitted to emergency with abdominal pain, nausea and vomiting initially classified as acute biliary pancreatitis etiology; a pedunculated gastric polyp intussuscepted into duodenum as a cause of acute pancreatitis was incidentally discovered, emergency endoscopic treatment and definitive treatment with open surgery was performed.


Subject(s)
Humans , Male , Aged , Intussusception/complications , Pancreatitis/etiology , Acute Disease , Intestinal Polyps/complications , Intussusception/diagnostic imaging , Intussusception/surgery , Pancreatitis/diagnostic imaging , Stomach Neoplasms/complications
9.
Article in English | LILACS, VETINDEX | ID: biblio-875392

ABSTRACT

Intussusceptions are unusual intestinal incidents which may result in acute and progressive or recurrent abdominal discomfort in foals. This condition asymptomatically affects newborn foals (3-12 months), are surgical emergencies when it involves the small intestine, especially the jejunum. Transabdominal ultrasound evaluation is an important diagnostic method, due to their size limitations for acute abdomen evaluation. The present report shows the importance of using transabdominal ultrasound in foals with acute abdomen.(AU)


As intussuscepções são acidentes intestinais incomuns e que podem resultar em desconforto abdominal agudo e progressivo ou recorrente em potros. Esta condição afeta potros neonatos de forma assintomática e de 3 a 12 meses são emergências cirúrgicas quando envolvem o intestino delgado, principalmente o jejuno. A avaliação ultrassonográfica transabdominal é um importante para o exame desses animais devido às limitações de seu tamanho para avaliações do abdômen agudo. O presente relato de caso mostra a importância da utilização do ultrassom transabdominal em potros com abdômen agudo.(AU)


Subject(s)
Animals , Abdomen/diagnostic imaging , Horses , Intussusception/diagnostic imaging , Intussusception/veterinary , Jejunum/pathology , Ultrasonography/veterinary
10.
Article in Korean | WPRIM | ID: wpr-62582

ABSTRACT

BACKGROUND/AIMS: The incidence of adult small bowel intussusception detected at CT has increased with advanced imaging techniques and universal utilization of CT scan. We aimed to identify factors that could predict the necessity of surgical intervention in adult patients with small bowel intussusception detected at CT during the past decade. METHODS: There were 39 cases of adult small-bowel intussusception detected at CT from January 2004 to June 2014. The data on clinical factors, radiological factors and outcomes were collected by retrospectively reviewing all available medical records. Patients were classified as surgical group and conservative group according to the outcome. Association between predictive factors and outcome was assessed by Fisher's exact test and logistic regression models. RESULTS: Among a total of 39 patients, there were 32 patients (82%) in the conservative group and 7 patients (18%) in the surgical group. Spontaneous reduction was confirmed at short-term follow-up studies (abdominal ultrasonography [n=14], single contrast small bowel series [n=14], CT [n=4]) in the conservative group. No recurrence occurred during the median follow-up period of 14.1 months (range, 0-67.5 months). Patients in the surgical group had significantly higher white blood cell (WBC) counts (OR 1.001, p=0.048), more frequent obstruction (n=4 vs. n=4, p=0.022) or leading point (n=5 vs. n=0, p<0.001) and longer intussuception length (OR 1.929, p=0.032). CONCLUSIONS: Factors associated with the necessity to resort to surgical intervention in adults with small bowel intussusceptions were higher WBC counts, presence of obstruction or leading point, and longer intussuception length. Conservative management can be considered with short-term follow-up for those without these predictive factors.


Subject(s)
Abdomen/diagnostic imaging , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Intestine, Small/diagnostic imaging , Intussusception/diagnostic imaging , Leukocyte Count , Male , Middle Aged , Odds Ratio , Radiography, Abdominal , Retrospective Studies , Tomography, X-Ray Computed , Ultrasonography
11.
Acta gastroenterol. latinoam ; 43(2): 126-9, 2013 Jun.
Article in Spanish | LILACS, BINACIS | ID: biblio-1157367

ABSTRACT

Intestinal intussusception is infrequent in adults. Unlike what happens in kids, it shows a demonstrable etiology in most cases: polyps, lipomas, hamartomas, malignancies, etc. Among diagnostic methods, CT scan is the study that yields the best results for the diagnosis, giving forth pathognomonic signs and favoring therapeutic decision-making. Two cases of intestinal intussusception in adults secondary to benign pathology are analyzed, stressing mainly the tomographic findings and some considerations about therapeutic decision-making based on tomographic results.


Subject(s)
Ileal Diseases , Intussusception , Intestinal Polyposis , Adult , Ileal Diseases/diagnostic imaging , Ileal Diseases/pathology , Female , Humans , Intussusception/diagnostic imaging , Intussusception/pathology , Male , Middle Aged , Intestinal Polyposis/diagnostic imaging , Intestinal Polyposis/pathology , Tomography, X-Ray Computed
12.
Indian J Pediatr ; 2009 Feb; ()
Article in English | IMSEAR | ID: sea-82853

ABSTRACT

OBJECTIVE: To evaluate if a correlation exists between the clinical and radiologic characteristics at presentation; and the success of conservative management, morbidity and outcome of patients with intussusception. METHODS: All patients (total 179) treated for intussusception in our unit between 1993 and 2003, were retrospectively reviewed to find out the effects of physical examination (general appearence, consciousness, body temperature, abdominal distention and tenderness, blood on rectal examination), laborat (leukocyte count) and radiologic (air-fluid level on X-ray, free abdominal fluid on ultrasonography) findings on selection of first step therapeutic modality, conservative management (reduction with barium or air) success rate and surgical complication (serosal defect, intestinal perforation) rate. Additionally, the patients were subdivided into three subgroups as group A (patients for whom surgical management was performed primarily), group B (the ones who were operated after failure of reduction attempt with barium or air), group C (patients who had successful conservative reduction). These groups were compared within each other with regard to duration of nasogastric suction, antibiotic therapy; onset of oral feeding and duration of hospitalization. The chi-square, Kruskal-Wallis and ANOVA tests were used for the statistical analysis and p value less than 0.05 was considered to be significant. RESULTS: Incidence of selecting conservative treatment primarily was lower in patients with moderate general appearence (p=0.02) and with free fluid on ultrasonography (p=0.007). Success rate of conservative treatment was lower in patients with moderate general appearence (p=0.000), lethargy (p=0.011), blood on rectal examination (p=0.004), air-fluid level on X-ray (p=0.039), free fluid on ultrasonography (p=0.001). Surgical complication rate was higher in patients with moderate general appearence (p=0.000), lethargy (p=0.007), air-fluid level on X-ray (p=0.009). In group A; the duration of N/G suction, antibiotic therapy and hospitalization was longer; the onset of oral feeding was later than the other two groups (p=0.000). In group B; the duration of N/G suction, antibiotic therapy and hospitalization was longer; the onset of oral feeding was later than group C (p=0.000). CONCLUSION: Moderate general appearence, lethargy and air-fluid level on X-ray not only decrease the success rate of conservative management, but increase the surgical complication rate as well. Thus, these parameters deserve more importance in the management scheme. Reduction with conservative management is the most important factor which decreases the morbidity. Morbidity is lower in cases who are operated after failure of conservative management than the ones for whom surgery is performed primarily. Thus, conservative management should be tried for all patients unless there is a clear cut contraindication such as peritonitis and/or pneumoperitoneum.


Subject(s)
Humans , Intussusception/diagnosis , Intussusception/epidemiology , Intussusception/drug therapy , Intussusception/diagnostic imaging , Intussusception/surgery , Intussusception/therapy , Intussusception/diagnostic imaging , Treatment Outcome
13.
Pakistan Journal of Medical Sciences. 2008; 24 (4): 629-631
in English | IMEMR | ID: emr-89594

ABSTRACT

Haemangiomas of small bowel are rare benign tumors. They present diversely, with intestinal obstruction being rare. We describe a two years old female baby with intestinal obstruction. Exploration revealed a diffusely infiltrating haemangioma of middle one third of ileum. Resection of affected segment and end to end bowel anastomosis was made. Post- operative recovery was un- eventful. Histopathological report was consistent with capillary haemangioma of small intestine


Subject(s)
Humans , Female , Hemangioma/diagnosis , Hemangioma, Capillary/complications , Hemangioma, Capillary/diagnosis , Intestine, Small/abnormalities , Intestinal Obstruction/diagnosis , Intestinal Obstruction/etiology , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/surgery , Intussusception/diagnosis , Intussusception/etiology , Intussusception/diagnostic imaging , Intussusception/surgery
14.
JAMC-Journal of Ayub Medical College-Abbotabad-Pakistan. 2006; 18 (3): 3-6
in English | IMEMR | ID: emr-77338

ABSTRACT

Adult intussusception is rare. It is expected to be found in 1/30,000 of all hospital admissions, 1/1300 of all abdominal operations, 1/30'1/100 of all cases operated for intestinal obstruction and one case of adult intussusception for every 20 childhood ones. The authors encountered 4 cases of adult intussusception. M:F ratio was 1:1. Mean age was 47years. Small bowel obstruction was documented in all. They were investigated by radiographs, ultrasound exam, barium studies, endoscopy and CT scan. All however were diagnosed at operation although some pre-operative suspicion was raised in one case. All had a laparotomy. Two were ileo-ileal and two ileo-caecal intussusceptions. One was chronic intussusceptions and three sub-acute. One intussusception had a malignancy [lymphoma] as a lead point. Two had a submucous lipoma at the apex. In an interesting case the suture knot from a recent small bowel anastomosis [2-3 weeks prior] was forming the lead point of the intussusception! The 2 ileo-ileal intussusceptions had segmental resection. Right hemicolectomy was done for the 2 ileo-caecal cases. 'Target lesion' and leumen-within-leumen were the CT hallmarks on review. Retrospective barium enema review failed to show the intussusception. This may suggest the intussusception may have been recurrent or chronic. All 4 recovered uneventfully and remained well. One patient was referred for chemotherapy for intestinal lymphoma. Adult intussusception remains a rare cause of abdominal pain. The treatment almost always is surgical


Subject(s)
Humans , Male , Female , Intussusception/epidemiology , Intussusception/diagnosis , Intestinal Obstruction , Intussusception/diagnostic imaging , Intussusception/diagnostic imaging , Digestive System Surgical Procedures , Endoscopy, Gastrointestinal , Rare Diseases , Adult
15.
Article in English | WPRIM | ID: wpr-68894

ABSTRACT

OBJECTIVE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.


Subject(s)
Abdomen/physiopathology , Abdominal Pain/etiology , Child , Child, Preschool , Diarrhea/etiology , Female , Humans , Infant , Intestine, Small/diagnostic imaging , Intussusception/diagnostic imaging , Irritable Mood , Male , Occult Blood , Ultrasonography, Doppler, Color , Vomiting/etiology
16.
Indian J Pediatr ; 2003 Jan; 70(1): 15-9
Article in English | IMSEAR | ID: sea-83760

ABSTRACT

OBJECTIVE: The present study aims at establishing the exact role and limitation of ultrasound in pediatric acute abdomen. METHODS: Fifty children less than 14 years of age presenting with acute abdomen were evaluated by US and other imaging modalities. The mean age of presentation was 3 1/2 years. Maximum number of cases were seen in less than two years of age. There were 17 cases of intussusception with US sensitivity and specificity of 88.2% and 100% respectively and positive and negative predictive values of 100% and 94.5% respectively. There were 13 cases of appendicitis. US was diagnostic in 11 with sensitivity and specificity of 91.6% and 97%; the positive and negative predictive values were 91.6% and 97% respectively. RESULTS: There were two cases each of congenital bands, adhesive intestinal obstruction, malrotation of bowel with volvulus, incarcerated inguinal hernia, hypertrophic pyloric stenosis, duplication cyst and pseudopancreatic cyst, one case each of trichobezoar, Meckel's diverticulum, ureteric calculus and worms as a cause of intestinal obstruction. The sensitivity of US for diagnosing specific cause of acute abdomen was found to be 77.5%. The main limitation of US was in the diagnosis of acute intestinal obstruction such as congenital bands and adhesions. CONCLUSION: US should now be considered as imaging modality of choice in pediatric acute abdomen. However, at times, plain radiography, conventional contrast studies and CT may be vital to reach the true diagnosis.


Subject(s)
Abdomen, Acute/diagnostic imaging , Adolescent , Appendicitis/diagnostic imaging , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Intussusception/diagnostic imaging , Male , Retrospective Studies , Sensitivity and Specificity
17.
El-Minia Medical Bulletin. 1999; 10 (1): 132-144
in English | IMEMR | ID: emr-50686

ABSTRACT

The aim of this study was to evaluate the values of both U/S and barium enema in diagnosis and hydrostatic reduction of acute non complicated intussusception in children. All these selected patients had no signs or symptoms of peritonitis with balanced serum electrolytes and the duration of symptoms was less than 48 hrs. Nasogastric tube inserted to decompress the stomach and IV cannula inserted for IV fluid replacement and sedated by diazepam. The diagnostic accuracy and sensitivity by both U/S and barium enema was 100% with positive sonographic target signs of intussusception [dough nut sign in TS and pseudo-kidney sign in LS]. 20 patients with non complicated acute intussusception were subjected to non- surgical reduction. They were divided into two groups for hydrostatic reduction of intussusception: Group A included ten patients subjected for reduction of intussusception by saline enema guided by U/S and Group B included also ten patients subjected for barium enema reduction under fluoroscopic guide. The results have shown that U/S was equal to barium enema in diagnosis of intussusception but U/S considered superior than barium enema in diagnosis and reduction of intussusception as it can detect another abdominal pathology that could not be diagnosed by barium enema as well as it can save the patient from the hazards of irradiation. Also, the results have revealed that hydrostatic reduction must be fulfilled to non complicated intussusception to save the patients from the hazards and cost of surgical treatment that must be done only in cases of failed hydrostatic reduction and in complicated cases


Subject(s)
Humans , Male , Female , Intussusception/diagnostic imaging , Intussusception/therapy , Ultrasonography , Barium Sulfate , Child , Enema
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