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Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report.

Shimazaki J, Nakachi T, Tabuchi T, Suzuki S, Ubukata H, Tabuchi T - World J Surg Oncol (2015)

Bottom Line: Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma.The patient had an uneventful recovery and was discharged on postoperative day 8.This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. shima-j@tokyo-med.ac.jp.

ABSTRACT
Adult intussusception is rare and usually caused by a tumor acting as the lead point. Therefore, laparotomy should be considered for the treatment. Laparoscopic procedures for use in cases of adult intussusception have been recently reported; however, there is no consensus regarding the safety and efficacy. Here, we describe a successful case of laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma, which was preoperatively suspected. An 87-year-old male presented with progressive abdominal distention and vomiting. Contrast radiography of the small intestine showed an ileal tumor, and magnetic resonance imaging indicated a target-like mass, consistent with an ileal intussusception. The patient was suspected with an intussusception due to an ileal lipoma, and laparoscopic surgery was performed. An approximately 10-cm-long ileal intussusception with a preceding tumor was present, and partial resection of the ileum, including the tumor, was performed. Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma. The patient had an uneventful recovery and was discharged on postoperative day 8. This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.

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Related in: MedlinePlus

T2-weighted magnetic resonance image. Reveals an intussusception as a target-like mass (A) and a hyper-intense tumor as the lead point (B).
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Fig2: T2-weighted magnetic resonance image. Reveals an intussusception as a target-like mass (A) and a hyper-intense tumor as the lead point (B).

Mentions: An 87-year-old male presented at our department with progressive abdominal distention and vomiting for 2 weeks. His medical history included hypertension and revealed that he had undergone laparoscopic-assisted ileocecal resection for cecal cancer in January 2004. Physical examination revealed a distended abdomen and a tender right lower quadrant. Laboratory test results, including serum levels of carcinoembryonic antigen and carbohydrate antigen 19–9, were within normal limits. Abdominal radiography revealed a prominently dilated small intestine with some air-fluid interfaces. A long tube was inserted to reduce the internal pressure of the small intestine, and Gastrografin contrast radiography was performed. It showed an approximately 40-mm-diameter ileal tumor (Figure 1). The ileus temporally improved, and subsequent magnetic resonance imaging (MRI) showed a target-like mass consistent with an ileal intussusception (Figure 2A,B). The patient was diagnosed with intermittent intussusception with an ileal tumor, which was suspected to be a lipoma. Laparoscopic surgery was performed in May 2014.Figure 1


Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report.

Shimazaki J, Nakachi T, Tabuchi T, Suzuki S, Ubukata H, Tabuchi T - World J Surg Oncol (2015)

T2-weighted magnetic resonance image. Reveals an intussusception as a target-like mass (A) and a hyper-intense tumor as the lead point (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4340886&req=5

Fig2: T2-weighted magnetic resonance image. Reveals an intussusception as a target-like mass (A) and a hyper-intense tumor as the lead point (B).
Mentions: An 87-year-old male presented at our department with progressive abdominal distention and vomiting for 2 weeks. His medical history included hypertension and revealed that he had undergone laparoscopic-assisted ileocecal resection for cecal cancer in January 2004. Physical examination revealed a distended abdomen and a tender right lower quadrant. Laboratory test results, including serum levels of carcinoembryonic antigen and carbohydrate antigen 19–9, were within normal limits. Abdominal radiography revealed a prominently dilated small intestine with some air-fluid interfaces. A long tube was inserted to reduce the internal pressure of the small intestine, and Gastrografin contrast radiography was performed. It showed an approximately 40-mm-diameter ileal tumor (Figure 1). The ileus temporally improved, and subsequent magnetic resonance imaging (MRI) showed a target-like mass consistent with an ileal intussusception (Figure 2A,B). The patient was diagnosed with intermittent intussusception with an ileal tumor, which was suspected to be a lipoma. Laparoscopic surgery was performed in May 2014.Figure 1

Bottom Line: Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma.The patient had an uneventful recovery and was discharged on postoperative day 8.This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. shima-j@tokyo-med.ac.jp.

ABSTRACT
Adult intussusception is rare and usually caused by a tumor acting as the lead point. Therefore, laparotomy should be considered for the treatment. Laparoscopic procedures for use in cases of adult intussusception have been recently reported; however, there is no consensus regarding the safety and efficacy. Here, we describe a successful case of laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma, which was preoperatively suspected. An 87-year-old male presented with progressive abdominal distention and vomiting. Contrast radiography of the small intestine showed an ileal tumor, and magnetic resonance imaging indicated a target-like mass, consistent with an ileal intussusception. The patient was suspected with an intussusception due to an ileal lipoma, and laparoscopic surgery was performed. An approximately 10-cm-long ileal intussusception with a preceding tumor was present, and partial resection of the ileum, including the tumor, was performed. Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma. The patient had an uneventful recovery and was discharged on postoperative day 8. This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.

Show MeSH
Related in: MedlinePlus