1/188. 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.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
2/188. Postoperative intussusception in childhood: case report.An eight year old female had laparotomy for general peritonitis due to acute appendicitis. Postoperative course was uneventful until the seventh day when abdominal pain, and distension and vomiting ensued which did not respond to conservative management. At repeat laparotomy, an ileoileal intussusception was found and reduced without difficulty. intussusception is an uncommon but important cause of postoperative intestinal obstruction. Since the typical features of intussusception are usually absent and radiology frequently unhelpful, a high index of clinical suspicion is necessary for early diagnosis and treatment to avoid strangulation and perforation.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
3/188. Painless intussusception and altered mental status.A 7-month-old child presented to the emergency department (ED) with 2 hours of painless, nonprojectile emesis and a normal mental status. Over a 3-hour period in the ED, the child remained pain-free, but developed hematemesis, hematochezia, and lethargy, progressing to unresponsiveness. The patient was evaluated for toxic ingestion, intracranial bleed, sepsis/meningitis, and intraabdominal pathology. The diagnosis was made by an abdominal ultrasound, which demonstrated an ileal-cecal intussusception that ultimately required surgical reduction. This case illustrates an insidious and poorly understood presentation of a common childhood affliction, as well as the utility of abdominal ultrasound in evaluating a hemodynamically stable patient with intussusception.- - - - - - - - - - ranking = 0.087446068022168keywords = pain (Clic here for more details about this article) |
4/188. A case of jejunal intussusception with gastrointestinal bleeding caused by metastatic testicular germ cell cancer.BACKGROUND/AIM: We report an unusual case of metastatic testicular germ cell tumor with its unusual presentation. METHOD: A patient presented to the San Joaquin General Hospital with gastrointestinal bleeding and obstruction and a testicular mass is described. The patient's clinical course is followed and the literature reviewed. RESULTS: The patient presented with jejunal intussusception due to metastatic testicular cancer. He was treated with orchiectomy and bowel resection followed by postoperative chemotherapy. CONCLUSION: This case illustrates the need to consider metastatic small-bowel obstruction and/or intussusception in patients presenting with testicular mass and abdominal pain. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
5/188. intussusception in adults.intussusception in adults is a rare entity that it is generally caused by definable intraluminal pathology. We report four cases of adult intussusception caused by lymphoma of the terminal ileum (2), an inflamed appendix (1) and a mucosal polyp (1). All presented with a variety of nonspecific and chronic symptoms, including abdominal pain, nausea and vomiting, consistent with partial small bowel obstruction. Only one patient had palpable masses in the abdomen. The most useful diagnostic radiological method was computed tomography (CT), which showed "target" lesions. The presence of the characteristic "target" lesion may obviate the need for further studies, including a barium enema. As in the cases reported here, treatment involves more than simple reduction; surgical resection is usually indicated.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
6/188. Sporadic peutz-jeghers syndrome in a Nigerian.peutz-jeghers syndrome is a rare condition of muco-cutaneous pigmentation and polyposis of the gut. Reports of its occurrence from the Black world have been infrequent. A case is presented of an 18 year old Nigerian girl with pigmentation of the inner lips and soles of both feet, and recurrent attacks of abdominal pain necessitating two surgical procedures for intestinal obstruction with removal, in both cases, of polyps. Problems of complications and therapeutic modalities are discussed.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
7/188. Rare complication of intestinal Crohn's disease: giant fibroid polyp.A 25-year-old male patient who had a brother with Crohn's disease was referred to our clinic with bloody diarrhea and crampy abdominal pain. After a plain erect abdominal X-ray, enteroclysis was performed, followed by abdominopelvic CT. Besides the radiological features of CD, both enteroclysis and CT revealed a big polypoid filling defect in the small intestine. The patient was surgically treated and the histopathology of the specimen revealed a giant fibroid polyp superimposed on CD, an extremely rare complication heretofore unmentioned in the radiology literature. In this report we discuss the role of enteroclysis in the diagnosis of complicated cases of long-standing CD. In addition, we also shed light on the importance of both enteroclysis and CT, with their complementary findings, in the radiological diagnosis of rare complicated cases of CD.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
8/188. Appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ: report of a case.Appendiceal intussusception is an uncommon pathologic condition; however, villous adenoma of the appendix is a distinctly rare entity. We report herein a case of appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ. A 67-year-old man was admitted to our hospital with a 1-year history of lower abdominal pain for investigation. barium enema showed a filling defect with an irregular surface in the cecum, and colonoscopy revealed a cecal tumor with a granular surface. Pathological examination of biopsy samples revealed tubulovillous adenoma with well-differentiated adenocarcinoma, and a diagnosis of cecal cancer in tubulovillous adenoma was made. Surgery was performed and the resected specimen was found to contain a tumor arising from the appendix. The tumor was 5.5 x 4.5 cm in size in the cecal cavity, and the appendix had invaginated into the cecum at its base. The cut surface of the appendix showed the villous tumor filling the appendiceal lumen and projecting into the cecal cavity. Microscopic examination revealed well-differentiated adenocarcinoma in tubulovillous adenoma. To the best of our knowledge, this is the first report of appendiceal intussusception caused by tubulovillous adenoma with carcinoma of the appendix.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
9/188. Long-standing painless intussusception in adults.Long-standing painless intussusception in adults is considered to be rare. We report three such cases with an emphasis on color Doppler results. In our three cases the indication for abdominal US was a palpable mass in all these cases, and intussusception was detected by US at a time when the patients had only very mild abdominal discomfort. Persistence of sufficient blood flow, as was suggested by the color Doppler results, was thought to be the most likely pathomechanism of long-standing painless intussusception. The underlying disease was tuberculosis in two of the three cases. Thus, when encountering patients with painless intussusception, tuberculosis must be kept in mind.- - - - - - - - - - ranking = 0.30606123807759keywords = pain (Clic here for more details about this article) |
10/188. The ultrasonic findings in intussusception of the blind loop in a jejunoileal bypass for obesity.A 34 year old woman with bowel bypass surgery and persistent abdominal pain had intussusception of the blind loop, which was visualized on an abdominal ultrasound examination. The ultransonic and radiographic findings are compared and presented. Ultrasound should prove to be an invaluable tool in evaluating abdominal pain in bowel bypass patients.- - - - - - - - - - ranking = 2keywords = abdominal pain, pain (Clic here for more details about this article) |
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