1/12. Idiopathic ileoileal intussusception in an adult with spontaneous reduction during enteroclysis: a case report.We report a rare case of recurring idiopathic ileoileal intussusception in an adult. Diagnosis was established with abdominal computed tomography (CT) and enteroclysis, which led to a spontaneous reduction of the invagination. After a short period of physical improvement, a follow-up CT showed a recurrence. Surgery proved the diagnosis, but no predisposing factor was found.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/12. Intestinal metastasis causing intussusception in a patient treated for osteosarcoma with history of multiple metastases: a case report.Intestinal intussusception caused by metastatic tumors is a very rare condition. Preoperative diagnosis is not easy because of the condition's rarity and because of mild abdominal physical presentation. We report on a patient with osteosarcoma who suffered from abdominal pain and emesis during the period of autologous peripheral blood stem cell transplantation. He had undergone tumor excision and radiotherapy several times prior to autologous peripheral blood stem cell transplantation because of multiple metastases. Intestinal metastasis was suspected initially by computed tomographic scan and sonogram and was proved by surgical resection and pathological findings. Clinicians caring for pediatric patients with osteosarcoma with a history of multiple metastases should consider the possibility of intestinal metastases when equivocal abdominal symptoms develop after intensive chemotherapy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/12. intussusception up to splenic flexure by cecal carcinoma in an adult: report of a case.A 73-year-old woman was admitted because of constipation and appetite loss. She was diagnosed as having intussusception caused by a colonic tumor, based on the results of physical examination and imaging such as ultrasonography, computed tomography and barium enema. Operation revealed that right colon from the cecum up to the hepatic flexure of the ascending colon was not fixed to the retroperitoneum, and a circular cecal carcinoma was invaginated to the splenic flexure of the transverse colon. We experienced a rare case of ileocolic intussusception up to the splenic flexure by a cecal carcinoma with mesenterium ileo-colicum commune in an adult.- - - - - - - - - - ranking = 11.23720847817keywords = physical examination, physical (Clic here for more details about this article) |
4/12. Perforated appendicitis in a child with Henoch-Schonlein purpura.Henoch-Schonlein purpura (HSP) is a common childhood vasculitis. abdominal pain is a common feature of HSP, often leading to surgical consultation for evaluation of possible intussusception. appendicitis is a rare complication of HSP, and in each of the 3 reported cases, appendectomy preceded the appearance of the purpuric rash. More often, unnecessary laparotomies are performed on patients in whom appendicitis is suspected, but who subsequently develop the characteristic purpura. This is the first reported case of appendicitis developing in a patient with the established HSP rash. This case is also the first report of perforated appendicitis in HSP. Clinical vigilance and serial physical and ultrasonographic examinations are needed to detect conditions necessitating surgery in patients with HSP.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/12. Retrograde gastric intussusception after myotomy for achalasia.Retrograde gastroesophageal intussusception has been rarely reported in the literature. risk factors include poor fixation of the stomach due to either long or loose mesenteric attachments; high intraabdominal pressure due to retching, physical exertion, or ascites; and hiatal hernia, which can lead to the development of a large gastroesophageal opening. An attempt at endoscopic reduction is reasonable, but laparotomy and manual reduction is usually required. We report a case of retrograde gastroesophageal intussusception in a patient with long-standing achalasia and two previous Heller myotomies.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/12. Colocolic intussusception in a three-year-old child caused by a colonic polyp.Colocolic intussusception is an uncommon cause of pediatric intestinal obstruction in north america; 95% of cases are ileocolic in location, with an equal percentage in which no pathologic lead point is evident on barium enema or laparotomy. In the last 20 years less than 3% of approximately 32,500 reported cases of intussusception originated in the colon. In a significant number of these cases juvenile polyps were identified as leading points. The majority of juvenile polyps occur in the rectosigmoid colon within the reach of a standard pediatric sigmoidoscope. These tumors most often cause painless hematochezia. Occasionally, juvenile polyps may grow large and serve as lead points for colocolic intussusception when located in the proximal colon. Pediatric patients presenting with documented colocolic intussusception should suggest the possibility of a colonic polyp or other mass lesion. Careful physical examination and barium studies should provide important diagnostic clues. Treatment is aimed at removing the lead point in patients presenting with intestinal obstruction. Colonoscopic polypectomy performed by an experienced endoscopist may serve as an alternative to surgical removal of the polyp. We report a case in a three-old-child of colocolic intussusception caused by a colonic polyp, and review some of the salient features of this clinical entity.- - - - - - - - - - ranking = 11.23720847817keywords = physical examination, physical (Clic here for more details about this article) |
7/12. Intraoperative endoscopic diagnosis of heterotopic gastric mucosa in the ileum causing recurrent acute intussusception.Heterotopic gastric mucosa (HGM) may be found anywhere in the gastrointestinal tract, most often in a Meckel's diverticulum. Approximately 30 cases of HGM, located in the small bowel beyond the ligament of Treitz and not associated with a Meckel's diverticulum, have been reported. They were most often revealed by intestinal intussusception, occasionally by perforation of an intestinal ulcer or intestinal bleeding. We report a 4-year-old boy who had three attacks of acute intestinal intussusception over a 5-month period resulting in surgery. Both physical examination and barium examination of the small bowel and large intestine were found to be normal between attacks. Peroperative palpation of the small bowel was normal during the three laparotomies. During the third operation, he underwent an intraoperative endoscopy (IOE), which revealed a polypoid mass 2 cm in diameter and 0.5 cm in height, 40 cm proximal to the ileocaecal valve. Histologic examination showed HGM with fundic glands, and chief and parietal cells. This case emphasizes the interest of IOE, the main indications of which are the localization of unknown sites of gastrointestinal bleeding and the search for hamartomatous polyps of the peutz-jeghers syndrome for polypectomy and/or segmental resection.- - - - - - - - - - ranking = 11.23720847817keywords = physical examination, physical (Clic here for more details about this article) |
8/12. intussusception of the appendiceal stump.intussusception of the appendiceal stump is a rare complication of appendectomy. A patient is described in detail and the eighteen previously reported instances are reviewed. Symptoms associated with this entity were abdominal pain (95%), vomiting (47%), blood per rectum (26%), and a palpable abdominal mass (68%). The onset of symptoms occurred within two weeks following appendectomy in 84% of the patients. barium enema examination was diagnostic in 87.5% of patients in whom it was performed. The diagnosis of intussusception of the appendiceal stump in the postoperative period is difficult because of the nonspecificity of symptoms, the paucity of physical findings, and the intermittent nature of the partial bowel obstruction. early diagnosis and appropriate treatment are facilitated by a thorough knownledge of this rare complication of appendectomy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/12. Obstruction of defunctionalized small bowel: its occurrence after bypass surgery for morbid obesity.Complications associated with jejunoileal bypass for morbid obesity are being recognized more frequently. A variety of mechanical obstructions in the defunctionalized small-bowel segment have recently been corrected in seven surgical patients. Volvulus of the defunctional limb was the most frequent cause of obstruction. intussusception, bypass enteritis, fascial hernia, and adhesive bands were also causes of obstruction. Radiographic contrast studies were valuable in establishing the preoperative diagnosis. The altered small-intestinal anatomy predisposed these patients to a uniquely subtle and dangerous form of closed-loop obstruction. Prompt recognition was based on patient history and physical findings. Characteristic roentgenographic findings often confirmed the diagnosis. Clinical suspicision of these small-bowel obstructive syndromes may lead to early surgical treatment.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/12. Radionuclide "Dance Sign.".The authors describe the radionuclide characteristics of the "Dance Sign." The "Dance Sign" is an uncommon but reliable observation found on physical examination in patients with intussusception.- - - - - - - - - - ranking = 11.23720847817keywords = physical examination, physical (Clic here for more details about this article) |
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