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At least 19 recordsLinked to original sources
PubMed1976

Adult intussusception; case report of recurrent intussusception and review of the literature.

An unusual case of lymphoma is presented in which small bowel intussusception due to a lymphomatous nodule caused an acute abdomen, requiring small bowel resection. Four weeks later a second intussusception caused intestinal obstruction, necessitating a second laparotomy and bowel resection. The high incidence of malignant tumor in adult cases leads us to recommend primary resection without manual reduction in all but rectosigmoid and selected small bowel cases.

Adult↗
PubMed1975

Recurrent intussusception in children.

Twenty-eight children with 35 recurrent intussusceptions were collected and analyzed from a series of 600 intussusceptions over 17 yr. The overall recurrence rate in the entire series was 5% with 11% recurring after hydrostatic barium enema reduction, and 3% after operative reduction. Twenty-three children had one recurrence each, four children had two recurrences, and one child had four recurrent intussusceptions. More than two-thirds of the patients had a recurrence within 6 mo of their first intussusception, and half of these presented earlier and with fewer signs and symptoms than the previous attack had manifested. Twenty-one of 30 recurrences were reduced with barium enema. Sixteen were operated on, reducing nine manually and resecting four others. Only two leading points were found, and in both instances resection was required. All but two of the intussusceptions were ileocolic. The previous mode of reduction of each intussusception did not set a trend for future treatment of recurrent intussusceptions in the same child. While operative reduction diminishes the chances of a recurrent intussusception and ileocolic resection eliminates it, there does not seem to be any indication for surgery as long as barium enema reduction is successful. We have never observed the hydrostatic reduction of an intussusception caused by a leading point.

Barium Sulfate↗
PubMed1992

Childhood deaths from intussusception in England and Wales, 1984-9.

OBJECTIVE: To assess the incidence of potentially avoidable factors contributing to death of children with intussusception. DESIGN: Review of children who died with intussusception in England and Wales between 1984 and 1989 from data of the Office of Population Censuses and Surveys, case notes, coroners' records, and necropsy reports. MAIN OUTCOME MEASURES: Unambiguous objective criteria such as failure to diagnose intussusception within 24 hours of admission. RESULTS: 33 children died of acute intussusception in England and Wales between 1984 and 1989 compared with 67 in the previous six years. Their median age was 7 months (range 2 months to 12 years), and two thirds were boys. Half of the deaths occurred at home or soon after arrival at hospital but 15 patients had surgery. Potentially avoidable factors contributing to death were identified in 20 (61%) children, all but three of whom had ileocolic intussusception. These factors were excessive delay in diagnosis, inadequate intravenous fluid and antibiotic therapy, delay in recognising recurrent or residual intussusception after hydrostatic reduction, and surgical complications. Of the 13 patients in whom no avoidable factors were identified, there were nine of 11 children with isolated small bowel intussusception, who tended to have atypical presentations. CONCLUSION: Although the mortality from intussusception has declined, there remains ample opportunity for improved management.

Child↗
PubMed1992

Adenovirus infection and childhood intussusception.

OBJECTIVE: To investigate the possible relationship between enteric adenovirus types 40 and 41 and intestinal intussusception in children. DESIGN: Prospective, case-control patient study. PATIENTS: Sixty-three consecutive children suspected clinically of having intestinal intussusception were enrolled in this study. Of these, 25 children (mean age, 1.4 years; range, 3 months to 5 years) had barium enema examination-proved intussusception. Age-matched normal controls (24) and controls with diarrhea (21) were obtained within 1 month of the index case. MEASUREMENTS AND RESULTS: Stools were tested for the presence of nonenteric adenovirus and enteric adenovirus using a monoclonal antibody-based enzyme immunoassay. Five (20%) of 25 children with intussusception had nonenteric adenovirus in their stools compared with one (4%) of 24 normal controls, none (0%) of 21 of the controls with diarrhea, and none (0%) of 37 patients suspected of having intussusception who had negative results on barium enema examination. However, no stool samples were positive for enteric adenovirus. CONCLUSIONS: Nonenteric adenovirus infection and intestinal intussusception may be associated. However, because enteric adenovirus was not found in any of the groups studied, no conclusions can be made regarding their possible influence on the risk for developing intussusception.

Adenovirus Infections, Human↗
PubMed1976

Leading points in childhood intussusception.

Children whose intussusception is caused by a specific pathologic lesion are harder to diagnose and have a higher morbidity than those with the idiopathic variety. We have collected and analyzed 31 such cases found in a series of over 500 intussusceptions. The average age of these children was greater than is usually found in most cases, and the duration of the signs and symptoms was also longer than is usually seen. Almost 50% presented with a picture of advanced small bowel obstruction. Fewer barium enemas were done (50%) and none was successful in reducing the intussusception. There was a higher number of ileo-ideal intussusceptions in this group. The commonest leading points were Meckel's diverticula, polyps, and duplications. All patients with leading points required operation; three-fourths had a bowel resection performed. This study of 569 cases suggests that older children with intussusception and children with recurrent intussusception do not necessarily have leading points causing their intussusceptions.

Adolescent↗
PubMed1977

Intussusception in the 1970s: indications for operation.

Eighty-one patients with proven intussusception were treated at the Cincinnati Children's Hospital from 1970-1974. One died. Seven of these had ileo-ileal intussusception, all treated surgically. Seventy-four had colonic components of their intussusceptions. In 58 of these patients (78%), reduction was attempted at barium enema, successfully in 32. Hydrostatic reduction was abandoned and the patient operated upon when the intussusception was not pushed out of the colon, when barium failed to reflux into several loops of ileum, or when there was a large persistent filling defect in the cecum or terminal ileum. Primary operation without barium enema was done in 16 patients. The appearance of intestinal obstruction by abdominal x-ray seemed to give the best warning about the complicated, incarcerated, or gangrenous intussusception. Primary operation is, therefore, advised for the patient with intussusception if there is x-ray evidence of intestinal obstruction. The age of the patient and the duration of his symptoms do not seem important in this regard, except as they correlate with peritonitis or obstruction. For the patient without peritonitis or intestinal obstruction, attempted reduction of the intussusception at barium enema seems safe and effective, regardless of the patient's age or duration of his symptoms.

Barium Sulfate↗
PubMed1992

The plain abdominal film in intussusception: the accuracy and incidence of radiographic signs.

The incidence of four plain abdominal film features associated with intussusception was recorded by four observers in 180 films of patients with intussusception mixed with 100 films of control subjects. The crescent sign and target sign were the most accurate indicators of intussusception. The target sign was the commoner being seen in 68% of films. Signs of small bowel obstruction were not useful in the diagnosis of intussusception. The soft tissue mass was the commonest indicator of intussusception. The soft tissue mass was found more commonly, however, than small bowel obstruction in the control subjects who did not have intussusception.

Child↗
PubMed1992

Nonischemic intussusception in childhood.

The classical presentation of intussusception consisting of severe abdominal pain, bloody stool, and a palpable abdominal mass leads to the correct diagnosis in majority of the patients. However, an atypical presentation often results in a delayed diagnosis as is commonly seen in nonischemic intussusception. The nonischemic intussusception is a distinct clinical entity that is characterized by a long history of less severe symptoms commonly noticed in older children. The incidence of diarrhea in this group is higher than in the acute variety of intussusception. This variant of intussusception requires a high degree of suspicion for the diagnosis in atypical clinical presentation. The present study summarises our experience treating 31 such cases of nonischemic intussusception during a period of 25 years from 1966 to July 1990.

Child↗
PubMed1992

The changing pattern of infantile intussusception in northern Nigeria: a report of 47 cases.

Infantile intussusception is not rare in Africa, but was reported to be relatively uncommon. This retrospective review of 47 infants with the diagnosis of intussusception included 38 boys and nine girls. Surprisingly, the clinical presentation is at variance with previous reports and beliefs about intussusception in tropical Africa, but is similar to those from Europe and North America. Contrary to expectation, about 70% of infants presented with the classical clinical picture of intussusception with the complete features of vomiting, 'colicky abdominal pain', blood mucoid stools and palpable abdominal mass. The other 30% presented with various combinations of the components of the tetrad. The small bowel was the leading point in 30 infants and the colon in 17. Of the small bowel variety, the two main types were the ileo-ileal and the ileocolic, while the ileocaecal and the various types of colo-colic intussusception were of large bowel origin. Morbidity was minimal. There were four deaths. Intussusception in this series differs in many respects from previous experience in Zaria.

Colonic Diseases↗
PubMed1992

Ileal intussusception in 16 young thoroughbreds.

The paper describes the outcome of 16 cases of short-ileal-ileal intussusception in young Thoroughbred horses. The intussusception was often associated with chronic or intermittent low grade abdominal pain. At laparotomy, only the intussusception was reduced in one horse; in another, a myotomy of the thickened stenosed intussusception was carried out after reduction. In 11 cases as ileocaecal bypass anastomosis was performed proximal to the intussusception after its reduction. One horse was subjected to euthanasia during operation because of irreversible intestinal wall damage and another because of intestinal rupture. One foal had a cardiac arrest following reduction of the intussusception. One horse was subjected to euthanasia 4 months post-operatively because of intractable abdominal pain caused by intestinal adhesions. Although several horses suffered episodes of post-operative abdominal pain, and 2 were subjected to a second laparotomy, 12 horses made an eventual complete recovery.

Abdominal Pain↗
PubMed1976

Intussusception of the appendix in children.

Intussusception of the appendix is uncommon and an unusual cause of ileocolic intussusception. The pediatric age group is most often affected. Appendiceal intussusception may present as primary appendiceal invagination but more commonly leads to secondary intussusception. Two cases of partial appendiceal intussusception leading to secondary intussusception are presented. Classification, symptomatology, radiographic appearance, and differential diagnosis are discussed.

Appendix↗
PubMed1992

[Reevaluation of US and CT findings in adult intussusception].

Computed tomographic (CT) and ultrasonographic (US) findings of 10 adult patients with 11 intussusceptions were retrospectively analyzed. Through close scrutiny of wall structures of intussusceptums and mesenteric fat, new features of adult intussusceptions were found: 1. The returning walls were thicker than the entering walls in 10 of 11 intussusceptums. 2. The neck of the returning wall was thicker than its head in eight of nine intussusceptums. 3. Longitudinal compression of the wall and venous congestion resulting from an inside out turning of the wall structure were thought to be the cause of thickening of the returning wall. 4. Invaginated mesenteric fat tended to be located at the head (apex) in two of seven intussusceptions, making differentiation from intussusception caused by lipoma difficult. 5. The leading masses were detectable as apical soft tissue density masses in eight of 10 intussusceptions. These findings contradict those of previous reports on adult intussusceptions.

Adult↗
PubMed1978

Colonic intussusceptions in children.

There is a high incidence of primary colonic intussusceptions in infants and children in Africa. The case histories of 37 patients are reviewed. Of the varieties described, the caecocolic intussusception (16 patients) presents as an intestinal upset, often mild, with symptoms of colic and vomiting. In many of these patients there is known to be an intestinal infestation with Ascaris lumbricoides. This often leads to a delay in establishing the correct diagnosis. Colocolic intussusception (13 patients) gives rise to more acute abdominal symptoms. On clinical assessment, signs of intestinal obstruction are found and there is usually an intra-abdominal mass which can be palpated in the left colon. Further confirmatory evidence of intussusception is the finding of occult blood in stools. There is an unusually high incidence of sigmoid intussusceptions in infants (8 patients). The diagnosis of this form of intussusception is often delayed owing to inadequate clinical assessment of prolapsed bowel at the anal orifice. The length of the prolapsed bowel, the curved nature of the prolapse and the possible demonstration of a sulcus between the prolapsed bowel and the anal canal wall, aid in diagnosis.

Cecal Diseases↗
PubMedDate not supplied

Radionuclide imaging of bowel infarction complicating small bowel intussusception in dogs.

Technetium-99m (99mTc)-pyrophosphate was investigated for use as an indicator of intestinal infarction in intussuscepted bowel. Irreducible intussusceptions were created in eight adult mongrel dogs. Technetium-99m-pyrophosphate was then injected intravenously 24 and 48 hrs later for external scanning. In six of the dogs, infarction developed in the intussusception, and each demonstrated increased uptake of 99mTc-pyrophosphate on in vivo scintiscans. The two dogs without infarction showed no increase uptake of the radionuclide. Well-counting and specimen scanning confirmed increased radionuclide in the infarcted intussusceptions. These observations suggest that 99mTc-pyrophosphate is a reliable indicator of the vascular compromise that sometimes occurs with intestinal intussusception.

Animals↗
PubMed1975

Barium findings in retrograde intussusception.

Four instances of antiperistaltic intussusception are presented. These serve to depict the varied roentgen appearances in both types of intussusception on barium study and emphasize two simple interpretational principles: (1) when contrast material is administered orad to an antegrade or caudad to a retrograde intussusception, it must first enter the intussusceptum; and (2) when barium is administered orad to a retrograde or caudad to an antegrade intussusception, it must first enter the intussuscipiens. Attention is also directed to tube related intussusceptions and to potential difficulty in their identification.

Aged↗
PubMed1992

[Primary colonic intussusception protruding from the anus in adults. Two cases].

The authors report two cases of colonic intussusception in the adult protruding from the anus--or colon-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.

Adolescent↗
PubMed1976

Intussusception in the older child- suspect lymphosarcoma.

Examination of the records of 378 children with intussusception at our institution revealed that 29 cases were caused by an identifiable intestinal lesion. A Meckel's diverticulum was the causative agent in 21 children, all of whom were under 2 yr of age. A previously undiagnosed ileal lymphosarcoma produced the intussusception in six other children, all between 6 1/2 and 9 yr of age. Our experience indicates that any child over 6 yr of age with the clinical findings of colicky abdominal pain, bloody stools, and a palpable mass plus the radiographic evidence of intussusception must be considered to have ileal lymphosarcoma until proven otherwise. Hydrostatic reduction of the intussusception must be accompanied by extensive small bowel reflux of barium in order to effectively rule out a small intestinal lesion. If this is not accomplished, surgery should be planned with the suspicion that a malignancy may be present. If this suspicion is confirmed by frozen section, the operation procedure should include wide surgical excision of the lesion along with the regional lymph nodes.

Child↗