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Introduction: Intussusception is the telescoping of one segment of the intestine into an adjacent segment, leading to obstruction, inflammation, and ischemia. In adults, it accounts for 5% of intussusception cases, representing 1%-5% of intestinal obstructions. It is typically secondary to intraluminal lesions (benign or malignant) or iatrogenic factors. Case Report: A 39-year-old male patient with a history of chronic gastritis presented with a three-month history of intermittent epigastric and left hypochondrial pain, which progressively increased in intensity and was associated with melena and rectal bleeding. On physical examination, he was hemodynamically stable, with mild tenderness in the left upper quadrant, no signs of peritoneal irritation, and positive findings for melena on digital rectal examination. Initial laboratory tests revealed no inflammatory response and normal hemoglobin levels. Upper gastrointestinal endoscopy and colonoscopy showed no abnormalities. Due to persistent abdominal pain, hepatobiliary ultrasound was performed, revealing a "target sign" suggestive of intussusception, which was confirmed with abdominal computed tomography. The patient underwent laparoscopic surgery, which identified an intestinal intussusception in the proximal ileum with a palpable intraluminal mass. Segmental resection and side-to-side anastomosis were performed. Histopathological analysis revealed a submucosal lipoma with ectopic pancreatic tissue. Conclusion: Intestinal intussusception in adults is rare and even less frequently associated with ectopic pancreatic tissue. [ABSTRACT FROM AUTHOR]

Introduction: Intussusception in adults is a rare manifestation after traumatic abdominal surgery, because after abdominal surgery patients often have functional bowel paralysis rather than increased intestinal motility. Case Report: 39-year-old male patient with acute intussusception appeared after surgery for diaphragmatic and splenic rupture. On day 7 postop, the patient has clinical manifestations of small bowel obstruction. Computed tomography image shows evidence of jejunum-jejunal intussusception. Exploratory laparotomy and resection of the necrotic bowel were performed. Rare cases such as intussusception should be observed postoperatively and in similar manifestations with careful examination of the characteristic CT findings, because of early detection and surgical intervention. with manual reduction can prevent the need for small bowel resection and possible unwanted complications. Discussion: Postoperative intussusception is rare and occurs primarily in the small intestine and should be indicated for emergency surgery in all cases, and this should be kept in mind by the surgeon and the resuscitator. The early diagnosis and intervention of patients increase the survival rate and the surgical efficiency. [ABSTRACT FROM AUTHOR]

Introducción: La intususcepción intestinal es la enfermedad donde un segmento de intestino proximal y su mesenterio se invaginan en el lumen del segmento adyacente distal. Se han descrito varias etiologías tanto benignas como malignas, su presentación en la población adulta es poco común, con síntomas inespecíficos y tardíos. Objetivo: Presentar el caso clínico de un paciente con obstrucción intestinal, secundaria a una intususcepción ileo-ileal, causada por presencia de tejido ectópico pancreático en un divertículo de Meckel. Caso clínico: Paciente masculino de 37 años de edad, con antecedentes de consumo de marihuana y cocaína, que presentó dolor abdominal de inicio súbito y se le diagnostica una obstrucción intestinal. La tomografía contrastada reveló intususcepción íleo-ileal causada por un divertículo de Meckel. Se realizó laparotomía exploratoria con resección segmentaria y anastomosis íleo-ileal. La histopatología confirmó la presencia de tejido pancreático ectópico. El paciente se recuperó sin complicaciones, tras la cirugía. Conclusiones: En este caso, se destaca la importancia de considerar la intususcepción íleo-ileal como una posible causa de obstrucción intestinal en adultos, especialmente cuando se asocia con un divertículo de Meckel que contiene tejido pancreático ectópico.

Introduction and aim: Intussusception is rare in adults and can occur in the small bowel and colon. Its atypical presentation makes the diagnosis difficult. The aim of the present study was to evaluate the causes, clinical characteristics, and treatment outcomes of adult intussusception and to determine whether there was an association between etiology and clinical presentation. Materials and methods: A retrospective study was carried out on patients above 18 years of age that were treated for intussusception at a tertiary care hospital, between 2000 and 2020. The findings were summarized utilizing descriptive and inferential statistics. Results: Twenty-eight cases were identified. Median patient age was 46 years (18-80) and median symptom duration was 18 days. Abdominal pain was the most frequent symptom (96.42%). The intussusceptions registered were enteroenteric (14), ileocecal (4), ileocolonic (4), colocolonic (5), and colorrectal (1). Intussusception etiology was benign in 15 cases, 9 were associated with malignancy, and 4 were idiopathic. Surgery was performed on 11 patients with enteroenteric intussusception and on all the cases of ileocecal, ileocolonic, colocolonic, and colorectal intussusception. There were 2 events of perioperative mortality (8%) and 8 of postoperative morbidity (32%). No significant differences were found regarding symptom duration or length of hospital stay, when the etiologic groups were compared. Conclusions: Intussusception is rare in adults. Diagnosis is a challenge because of the nonspecific signs and symptoms. Surgical resection should be considered in the definitive treatment and management should be individualized according to the patient’s comorbidities, clinical presentation, and risk of malignancy. Resumen: Introducción y objetivos: La intususcepción es infrecuente en adultos y puede ocurrir en intestino delgado y colon. Su presentación atípica hace complejo el diagnóstico. El objetivo de este estudio fue evaluar las causas, características clínicas, desenlaces del tratamiento y determinar si existe asociación entre etiología y presentación clínica. Material y métodos: Estudio retrospectivo en un centro de tercer nivel, en pacientes mayores de 18 años con intususcepción tratados entre 2000 y 2020. Se utilizó estadística descriptiva e inferencial para resumir los hallazgos. Resultados: Se identificaron 28 casos, con mediana de edad de 46 años (18-80) y duración de síntomas 18 días. El dolor abdominal fue el síntoma más frecuente (96.42%). Se registraron 14 intususcepciones entero-entéricas, 4 ileocecales, 4 ileocolónicas, 5 colo-colónicas, y una colorrectal. Quince de las intususcepciones fueron de etiología benigna, 9 asociadas a malignidad y 4 idiopáticas. Se realizó cirugía en 11 pacientes con intususcepción entero-entérica y en todos los casos de intususcepción ileocecal, ileocolónica, colo-colónica y colorrectal. Se presentaron 2 eventos de mortalidad perioperatoria (8%) y 8 de morbilidad postoperatoria (32%). No hubo diferencia significativa en la duración de los síntomas, ni en estancia hospitalaria al comparar los grupos etiológicos. Conclusiones: La intususcepción es rara en adultos. El diagnóstico es un reto debido a los signos y síntomas inespecíficos. Para el tratamiento definitivo, se debe considerar la resección quirúrgica, individualizando de acuerdo a las comorbilidades del paciente, presentación clínica y riesgo de malignidad.

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La intususcepción intestinal es la invaginación intraluminal de un segmento proximal de intestino y su mesenterio dentro de otro adyacente o distal. Su presentación en la edad adulta es infrecuente1. Representa el 5 % de todos los casos de invaginación, que corresponde de dos a tres casos por 1.000.000 personas al año, con un pico de incidencia entre los 30 y 50 años, sin predominio de sexo 2.

Intussusception in adults is an extremely rare surgical clinical entity, its main etiology in this population is generally attributed to malignant origin, benign pathology is less frequent and presents a challenge for pre-surgical diagnose, since its presentation is non-specific and variable. Below is a clinical case that debuted with a clinical picture of intermittent pain in the right upper quadrant, manifesting exacerbation and non-specific laboratory tests, for which initially pathology of biliary origin was thought to be the reason for the pain, and therefore, an ultrasound of the liver and bile ducts was performed, observing signs suggestive of intussusception secondary to a lipoma, for which a simple abdominal tomography was performed to corroborate the diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: colonic polyps affect up to 1% of the school age population, which usually cause lower digestive bleeding and pain; however, large ones can cause intussusception. Case presentation: nine-year-old female patient, previously healthy. She presents abdominal pain of 40 days duration, associated with rectal bleeding in recent days. Through imaging studies, she was diagnosed with colo-colic intussusception (CCI). Hydrostatic reduction was unsuccessful, so reduction was performed by laparotomy. The polyp was subsequently resected by colonoscopy. According to histopathological report, it was a juvenile polyp. Conclusions: CCI can be secondary to large or giant polyps. [ABSTRACT FROM AUTHOR]

Introducción: La oclusión intestinal constituye la segunda causa de abdomen agudo quirúrgico y el 20 % de los ingresos en los servicios de urgencia; algunas revisiones muestran que se producen cada año más de 9000 muertes por esta causa. Objetivo: Presentar un paciente oncológico al cual se le realizó una gastrostomía y posteriormente se complicó con una intususcepción. Caso clínico: Paciente de 59 años de edad, al cual se le realizó una gastrostomía alimentaria al presentar disfagia. Días más tarde el paciente se complicó con una oclusión intestinal y falleció en un corto periodo. Conclusiones: La intususcepción es una enfermedad infrecuente en adultos, con una presentación clínica poco específica. Los síntomas cardinales son el dolor de tipo cólico, vómitos, distención abdominal y detención del tránsito intestinal.

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La intususcepción como causa de obstrucción intestinal en el adulto es una entidad muy rara, la mayoría es secundario a una neoplasia de intestino delgado benigna o maligna. Los lipomas son tumores benignos raros, considerados neoplasias del tejido adiposo maduro sin pleomorfismo que se hallan en el tubo digestivo como tumores bien delimitados de la submucosa, y se encuentran con mayor frecuencia dentro de la pared del intestino delgado. Presentamos el caso de un varón de 72 años que es intervenido quirúrgicamente por obstrucción intestinal, y un diagnóstico intraoperatorio de intususcepción de intestino delgado secundario a un angiolipoma submucoso según anatomía patológica. La intususcepción en adultos es rara, y que la misma se deba a otra entidad benigna inusual, es aún más raro. El estudio tomográfico es útil, pero la mayoría se diagnostican en la etapa intraoperatoria. La resección “en bloque” es lo más recomendado debido a la sospecha de malignidad.

Introducción. La intususcepción del apéndice corresponde a su invaginación en el ciego. Existen varias causas, pero la endometriosis ha sido informada pocas veces. Aunque el diagnóstico se debe sospechar clínicamente, por lo general su causa solo se determina en el intraoperatorio, donde se deben tener en cuenta causas oncológicas que requieran una resección amplia. Caso clínico. Mujer de 21 años que consultó por dolor abdominal agudo generalizado. Se practicó una tomografía computarizada de abdomen, observando una intususcepción del apéndice en el ciego, estriación de la grasa pericecal y adenomegalias. Se realizó laparoscopia diagnóstica encontrando intususcepción casi completa del apéndice cecal, de aspecto neoplásico. Se convirtió a laparotomía para proceder a hemicolectomía derecha, con vaciamiento ganglionar y anastomosis del íleon al colon transverso. Discusión. La sospecha clínica de intususcepción debe corroborarse mediante ecografía, tomografía o estudios baritados. El tratamiento siempre es quirúrgico, como en el caso de nuestra paciente, quien evolucionó de forma adecuada y continuó asintomática después de un año de seguimiento. Conclusión. El diagnóstico temprano de la intususcepción permite realizar tratamientos quirúrgicos menos agresivos y disminuye el riesgo de filtración de la anastomosis. Se debe tener en cuenta el diagnóstico de endometriosis como posible causa. Se debe realizar el manejo complementario por parte de ginecología.

Intestinal invagination occurs when an intestinal segment is introduced into another segment. The appendicular presentation is less common and affects predominantly infants. The diagnosis is corroborated during the surgical intervention which consists of de-invagination followed by surgical removal of the appendix, if the latter is not possible then a wide resection or right hemicolectomy is indicated. We present the case of a 4-year-old girl who attended with a history of abdominal pain, anorexia, vomiting and fever; an abdominal ultrasound showed intestinal agglomeration and a rounded mass. The surgical findings included appendicular invagination that affected the cecum, the lesion was resected until the ascending colon. An ileostomy was performed, the anatomopathological findings indicated necrosis of the appendix. Three months later the normal intestinal transit was restored. Appendicular intussusception has non-specific symptoms and could be mortal in Peru. A detailed clinical history may help in diagnosing and offering proper treatment. [ABSTRACT FROM AUTHOR]

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción. El apéndice cecal invertido, inversión apendicular o intususcepción apendicular, corresponde a una condición anatómica descrita en 1859. La primera operación de invaginación apendicular se realizó en 1890, y desde entonces se han descrito diferentes técnicas quirúrgicas y endoscópicas para el tratamiento de esta alteración. Casos clínicos. Se presentan dos casos de pacientes a quienes se les indicó colonoscopia como parte de estudio de dolor abdominal y diarrea y se identificó una intususcepción apendicular completa y apendicitis y una inversión del muñón apendicular. Resultados. Mediante la colonoscopia se hizo el diagnóstico de apendicitis aguda en una de las pacientes, quien presentaba inversión apendicular completa tipo 5, que fue tratada con manejo farmacológico y seguimiento clínico. En la otra paciente hubo un hallazgo incidental de inversión del muñón apendicular tipo 3. Conclusiones. Durante la realización de estudios colonoscópicos, se debe tener en cuenta el diagnóstico de intususcepción apendicular o apéndice invertido, para evitar intervenciones erróneas, como polipectomías, que generen riesgo potencial en los pacientes.

To report the case of a patient with appendicular intussusception (AI), an infrequent condition secondary to a focus of endometriosis, a pathology that has increased incidence in recent years. Material and Method: Clinical case, history and images obtained from the clinical file and intraoperative records with the consent of the patient. Results: A 35-year-old woman with abdominal pain. Colonoscopy study showing a 15 x 8 mm lesion in the appendicular ostium intussuscepted to the cecal lumen, and a computerized tomography (CT) enteroclysis confirming AI. A laparoscopic ileocecal resection is performed, demonstrating invagination of the appendix secondary to an endometrioma focus. Discussion: AI is a rare condition, with an incidence close to 0.01% in the general population. Benign pathologies are the main cause (77%), endometriosis being the most frequent cause. Conclusion: AI due to endometriosis is anecdotal, with unspecific symptoms. The available studies can adequately guide the presence of AI, however, on some occasions it can be confused with neoplastic pathologies, where surgery is important to elucidate the etiology. [ABSTRACT FROM AUTHOR]

Introducción. La invaginación intestinal o intususcepción es el deslizamiento de una parte del intestino dentro de otra adyacente. Es la causa más común de obstrucción intestinal en niños entre 3 meses y 6 años de edad, con una baja incidencia en adultos, correspondiente al 1 % del total de los cuadros obstructivos en el adulto. Su localización en colon es poco frecuente, pero conviene prestar especial atención por su asociación a lesiones malignas. Caso clínico. Varón de 39 años que acude a Urgencias con cuadro de obstrucción intestinal secundario a una invaginación en sigmoide. Se intenta reducción endoscópica, sin éxito, por lo que se indicó cirugía urgente, realizando sigmoidectomía y anastomosis colorrectal. El resultado anatomopatológico informó un adenoma de gran tamaño como causante de la invaginación. Conclusión. Existen controversias respecto al manejo endoscópico en invaginación intestinal en los adultos, especialmente en el colon, debido al elevado porcentaje de etiología tumoral maligna, recomendándose actualmente la resección en bloque sin reducción, para minimizar el riesgo de potencial siembra tumoral.

A Meckel's diverticulum (MD) is an embryonic remnant of the omphalomesenteric duct. Although most MDs are usually asymptomatic, pediatric patients tend to present serious complications more frequently (4-25% of cases), mainly in digestive tract bleeding, intestinal obstruction, and perforation, which have a high potential to compromise the patient's life. An ectopic pancreas (EP) is pancreatic tissue found outside the pancreas, usually in the stomach, duodenum, and jejunum. It is typically asymptomatic but can increase the risk of complications in the MD. A clinical case of a female infant with an MD complicated with bleeding and ileo-ileal intussusception is presented, in which the histopathological finding of type 1 ectopic pancreatic tissue was also found based on the Heinrich classification, being an entity uncommon in our environment. An EP arising within an MD is infrequent, requiring clinical attention and timely preoperative diagnosis to prevent and treat associated severe complications. This continues to be a superior challenge for the clinician and requires a multidisciplinary team for comprehensive treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Palma Zapata et al.)

The gold standard for bariatric surgery is the laparoscopic gastric bypass, which consists in forming a small gastric pouch and a Roux-en-Y anastomosis. We present the case of a 41-year-old female who underwent a laparoscopic gastric bypass 8 years prior to her admission to the emergency room, where she arrived complaining of severe and colicky epigastric abdominal pain. The abdominal computed tomography showed a jejuno-jejunal intussusception, for which the patient underwent urgent exploratory laparotomy with intussusception reduction. Intestinal intussusception is a possible postoperative complication of a Roux-en-Y gastric bypass., (Copyright: © 2023 Permanyer.)