Spontaneous ileo-ileal and ileo-caecal intussusception in adults: Report of two cases.

Year 2014, , 43 - 48, 01.03.2014

Erdal Uysal Mehmet Dokur Ahmet Orhan Gürer Hasan Bakır Mehmet Ali İkidağ

https://doi.org/10.5505/sakaryamj.2014.63634

Abstract

Having defined as a proximal intestinal segment interpenetrating an adjacent distal intestinal segment lumen in the gastrointestinal system intussusception or invagination, is the most common cause for acute abdomen in children following acute appendicitis.Contrary to childhood period intestinal intussusceptions is rarely encountered among adults. Etiology, clinical presentation and treatment methods are different in adults as well. In etiology of an adult intussusception mostly there are malignant, non-malignant and iatrogenik reasons. İn rare cases the etiology is idiopathic or spontaneous. Spontaneous intussusceptions are mostly seen in small bowel. Diagnose of an adult intussusception can be overlooked or delayed when it is rarely encountered and atypically presented. Treatment is surgical in most cases. In this article, two adult cases of spontaneous ileal and ileo-caecal intussusception was analysed and presented under current literature considering clinical outlook, diagnose and treatment

Keywords

spontaneous intussusception, adult, ileum, caecum

Erişkinde spontan ileo-ileal ve ileo-çekal intussussepsiyon: İki olgu sunumu.

Abstract

Proksimal barsak segmentinin komşu distal barsak segmenti içerisine penetrasyonu olarak tanımlanan gastrointestinal intussussepsiyonu veya invajinasyonu,çocuklarda akut apandisitten sonra akut batının en sık nedenidir.Çocukluk döneminin aksine erişkinlerde barsak intussussepsiyonları daha az görülür.Erişkin intussussepsiyonlarının etyoloji,klinik prezentasyon ve tedavi yöntemleri de farklıdır. Erişkinlerin barsak intussussepsiyonlarının etyolojisinde çoğunlukla malignant, non-malignant ve iyatrojenik bir neden vardır. Çok az olguda intussussepsiyonun etyolojisi idyopatik ya da spontandır. Spontan olarak gelişen intussussepsiyonlar çoğunlukla ince barsakta görülür. Erişkin intussussepsiyonun tanısı nadir karşılaşılması ve atipikprezentasyonlu olması nedenleriyle atlanabilir ya da geç konulabilir. Olguların hemen hepsinde tedavi cerrahidir. Bu yazıda spontan ileal ve ileo-çekal intussussepsiyonlu iki erişkin olgu klinik görünüm,tanı ve tedavi açısından güncel literatür ışığında gözden geçirilerek sunuldu.

Keywords

spontan intussussepsiyon, erişkin, ileum, çekum

References

• Yalamarthi S, Smith RC. Adult intussusception:case reports and review of literature. Postgrad Med J 2005;81:174-7.
• Korkmaz Ö, Yılmaz HG, Taçyıldız İ, Baç B, Çevik S. Erişkinlerde Görülen İnvajinasyon Olgularının Değerlendirilmesi. Dicle Tıp Dergisi, 2007;34(3):182-6.
• Wang N,Cui XY,Liu Y,Long J,Xu YH,Guo RX,Guo KJ. Adult intussusception:A retrospective review of 41 cases. World J Gastroenterol 2009;15(6):3303-8.
• FelixEL,Cohen MH,Bernstein AD,et al. Adult intussusception: case report of recurrent intussusception and review of the literature.Am J Surg 1976;131:758–61.
• Brooks A,Bebington BD,Lucas S,et al. Intussusception caused by blunt abdominal trauma. J Trauma 1999;47:156–7.
• Eke N, Adotey JM. Postoperative intussusception, causal or casual relationship? Int Surg 2000;85:303–8.
• Meyerson S,Desai TK,Polidori G,et al. A case of intussusception and lymphoid hyperplasia in a patient with AIDS. Am J Gastroenterol 1993;88:303–6.
• Azar T, Berger DL. Adult intussusception. Ann Surg 1997;226:134–8.
• Reijnen HA,Joosten HJ,DeBoer HH. Diagnosis and treatment of adult intussusception. Am J Surg 1989;158:25–8.
• BoyleMJ, Arkell L J,Williams JT. Ultrasonic diagnosis of adult intussusception. Am J Gastroenterol 1993;88:617–8.
• Bar- Ziv J, Solomon A. Computed tomography in adult intussusception. Gastrointest Radiol 1991;16:264–6.
• Gayer G.Intussusception--not only a childhood disease. Isr Med Assoc J. 2001;3(12):962.
• Erkan N, Haciyanli M, Yildirim M, Sayhan H, Vardar E, Polat AF. Intussusception in adults: an unusual and challenging condition for surgeons. Int J Colorectal Dis 2005; 20: 452-6.
• Guillén Paredes MP, Campillo Soto A, Martín Lorenzo JG, et al. Adult intussusception-14 case reports and their outcomes. Rev Esp Enferm Dig 2010;102:32-40.
• Karamercan A, Kurukahvecioglu O, Yilmaz TU, Aygencel G, Aytaç B, Sare M. Adult ileal intussusception: an unusual emergency condition. Adv Ther. 2006 ;23(1):163-8.
• Reijnen HA,Joosten HJ,De Boer HH. Diagnosis and treatment of adult intussusception. Am J Surg 1989;158:25–8.
• Nesbakken A, Haffner J. Colo-recto-anal intussusception:casereport. Acta Chir Scand 1989;155:201–4.
• Lin F,Setya V,Signor W. Gastroduodenal intussusception secondary to a gastric lipoma: a case report and review of literature. Am Surg 1992;58:772–4.
• Atila K, Terzi C, Obuz F, Yılmaz T, Füzün M. Symptomatic intestinal lipomas requiring surgical interventions secondary to ileal intussusception and colonic obstruction: report of two cases. Ulus Travma Acil Cerrahi Derg 2007;13(3):227-31.
• Saïji E, Ayadi-Kaddour A, Ben Slama S, Ghariani B, Chelly-Ennaiffer I, Lahmar-Boufaroua A, Goutallier-Ben Fadhel C, Khalfallah MT, Mzabi-Regaya S.Inflammatory fibroid polyp of the ileum presenting as intussusception: a case report in an adolescent. Tunis Med. 2006 ;84(7):454-7.
• M Athanasios, Yiallourou A, Samanides L, Dafnios N, Anastasopoulos G, Vassiliou I, Theodosopoulos T. Intussusception of the bowel in adults: A review. World J Gastroenterol 2009 28; 15(4): 407-11.
• Youssef S, Jaidane M, Sakhri J, Belltaifa D, Kehila M.Intestinal invagination after vagotomy in adults. [Article inFrench] Ann Chir 2001;126:786-8.
• Korkmaz Ö,Yılmaz HG,Taçyıldız İ, Akgün Y. Erişkinlerde İnvajinasyon. Ulus Travma Acil Cerrahi Derg 2009;15(2):154-8.
• Toso C, Erne M, Lenzlinger PM, Schmid JF, Büchel H,Melcher G, et al. Intussusception as a cause of bowel obstruction in adults. Swiss Med Wkly 2005;135:87-90.
• Karahasanoglu T, Memisoglu K, Korman U, Tunckale A,Curgunlu A, Karter Y.Adult intussusception due to inverted M e c k e l’s diverticulum:laparoscopic approach. Surg Laparosc Endosc Percutan Tech 2003;13:39-41.
• Ahmad J, Lakomiec B, Loughrey MB. Image of the month. Spontaneous adult intussusception presenting as rectal bleeding.Clin Gastroenterol Hepatol. 2011 ;9(2):A18.
• Bilgin F, Özcan Ö, Dönmez M, Şentatar E, Ayşan E, Kaygusuz A. Yetişkinde İnce Bağırsak İnvajinasyonu: Nadir Bir Olgu.Bakırköy Tıp Dergisi2012;8:47-9.
• Begos DG, Sandor A, Modlin IM. The diagnosis and management of adult intussusception. Am J Surg 1997;173:88-94.
• Anderson DR. The pseudokidney sign. Radiology 1999;211:395-7.
• David MW, MD and Joseph K.T. Lee, MD. Adult intussusception detected at CT or MR imaging: clinical-imaging correlation. Radiology. 1999;212: 853–60.
• Lebeau R, Koffi E, Diané B, Amani A, Kouassi JC. Acute intestinal intussusceptions in adults: analysis of 20 cases.Ann Chir 2006; 131:447-50.
• Kitamura K, KitagawaS,Mori M,et al. Endoscopic correction of intussusception and removal of a colonic lipoma. Gastrointest Endosc 1990;36:509–11.
• Barussaud M, Regenet N, Briennon X, et al. Clinical spectrum and surgical approach of adult intussusceptions: a multicentric study.Int J Colorectal Dis. 2006;21(8):834-9.
• Nagomey DM,Sarr MG, Mc Ilrath DC. Surgical management of intussusception in the adult. Ann Surg 1981;193:230–6.
• Zubaidi A, Al-Saif F, Silverman R. Adult intussusception: a retrospective review. Dis Colon Rectum 2006; 49: 1546-51.
• El-Khalil T, Mourad FH, Uthman S. Sigmoid lipoma mimicking carcinoma: case report with review of diagnosis and management. Gastrointest Endosc 2000;51(4 Pt 1):495-6.