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Triple jejuno-jejunal intussusception due to metastatic renal cell carcinoma.

Massy Budmiger AS, Nagy V, Hürlimann S, Metzger J - J Surg Case Rep (2015)

Bottom Line: Intra-operative findings were five intramural masses 15 cm distal to the ligament of Treitz over a total length of 50 cm.A primary en bloc resection with an end-to-end anastomosis was carried out.The postoperative course was uneventful.

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Affiliation: Department of Visceral Surgery, Hospital of Lucerne, Lucerne, Switzerland anne-sophie.massybudmiger@luks.ch.

No MeSH data available.


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Dimple formation on the serosa due to traction of the tumour.
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RJV047F4: Dimple formation on the serosa due to traction of the tumour.

Mentions: According to a post-mortem review by Saitoh et al. RCCs metastasize to the small intestine in 14.6% (229/1571) of cases [4]. Solitary metastatic RCCs in the small intestine are very rare, with most patients having further metastases elsewhere [5]. The survival of patients with metastatic RCCs has significantly improved since the introduction of sequential vascular endothelial growth factor receptor and mammalian target of rapamycin-targeted therapies [6]. Thus, the observation of metastases in formerly uncommon sites during the course of the disease might be more frequent than it was in earlier decades. Intussusception is a rare cause of bowel obstruction in adults and almost always associated with a definable lesion [7]. It may occasionally result from a pedunculated growth of a small bowel tumour. Typically, the tumour will be sub-mucosal and give rise to dimple formation by traction on the serosa (Fig. 4) [3]. Preoperative diagnosis of intussusception is difficult. CT is the most useful diagnostic procedure [8]. Other diagnostic tools such as upper gastrointestinal series, colonoscopy and flexible sigmoidoscopy are frequently non-diagnostic [7, 9]. The management of adult intussusception remains controversial, although metastasectomy may extend patient survival [5]. Thus, surgical resection of the involved intestinal segment has been recommended as the treatment of choice [8].Figure 4:


Triple jejuno-jejunal intussusception due to metastatic renal cell carcinoma.

Massy Budmiger AS, Nagy V, Hürlimann S, Metzger J - J Surg Case Rep (2015)

Dimple formation on the serosa due to traction of the tumour.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400532&req=5

RJV047F4: Dimple formation on the serosa due to traction of the tumour.
Mentions: According to a post-mortem review by Saitoh et al. RCCs metastasize to the small intestine in 14.6% (229/1571) of cases [4]. Solitary metastatic RCCs in the small intestine are very rare, with most patients having further metastases elsewhere [5]. The survival of patients with metastatic RCCs has significantly improved since the introduction of sequential vascular endothelial growth factor receptor and mammalian target of rapamycin-targeted therapies [6]. Thus, the observation of metastases in formerly uncommon sites during the course of the disease might be more frequent than it was in earlier decades. Intussusception is a rare cause of bowel obstruction in adults and almost always associated with a definable lesion [7]. It may occasionally result from a pedunculated growth of a small bowel tumour. Typically, the tumour will be sub-mucosal and give rise to dimple formation by traction on the serosa (Fig. 4) [3]. Preoperative diagnosis of intussusception is difficult. CT is the most useful diagnostic procedure [8]. Other diagnostic tools such as upper gastrointestinal series, colonoscopy and flexible sigmoidoscopy are frequently non-diagnostic [7, 9]. The management of adult intussusception remains controversial, although metastasectomy may extend patient survival [5]. Thus, surgical resection of the involved intestinal segment has been recommended as the treatment of choice [8].Figure 4:

Bottom Line: Intra-operative findings were five intramural masses 15 cm distal to the ligament of Treitz over a total length of 50 cm.A primary en bloc resection with an end-to-end anastomosis was carried out.The postoperative course was uneventful.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Visceral Surgery, Hospital of Lucerne, Lucerne, Switzerland anne-sophie.massybudmiger@luks.ch.

No MeSH data available.


Related in: MedlinePlus