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Chronic ileocolic intussusception due to transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy: a case report.

Saka R, Sasaki T, Matsuda I, Nose S, Onishi M, Fujino T, Shimomura H, Otsuka Y, Kajimoto N, Hirota S, Oue T - Springerplus (2015)

Bottom Line: The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg.Since hydrostatic reduction was unsuccessful, laparotomy was performed, which showed unreducible ileocolic intussusception with a marked edematous ileum and mesentery.Ileocecal resection without lymph node dissection was carried out, and a histological examination of the resected specimen revealed the transmural infiltration of diffuse large B-cell lymphoma of the terminal ileum.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 6638501 Japan.

ABSTRACT
Chronic intussusception, defined as intussusception continuing over 14 days, is rare in children. We herein report a case of chronic ileocolic intussusception caused by the transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy. The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg. Upon admission to our hospital, ultrasonography and enhanced computed tomography (CT) of the abdomen showed ileocolic intussusception. A retrospective examination of abdominal CT led us to suspect that the intussusception had initially appeared 5 weeks before admission, presumably coinciding with the beginning of the patient's abdominal symptoms. Since hydrostatic reduction was unsuccessful, laparotomy was performed, which showed unreducible ileocolic intussusception with a marked edematous ileum and mesentery. Ileocecal resection without lymph node dissection was carried out, and a histological examination of the resected specimen revealed the transmural infiltration of diffuse large B-cell lymphoma of the terminal ileum. The patient's postoperative course was uneventful, and adjuvant chemotherapy was administered. This case illustrates the diagnostic challenges of confirming 'chronic' intussusception in older children.

No MeSH data available.


Related in: MedlinePlus

Intraoperative findings. a Ileocolic intussusception was confirmed. Laparoscopic reduction failed. b The mesentery was markedly thickened, and the ileum was edematous. Although the tumor (arrow) in the terminal ileum was partially reduced, manual reduction was unsuccessful. Ileocecal resection was performed.
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Fig3: Intraoperative findings. a Ileocolic intussusception was confirmed. Laparoscopic reduction failed. b The mesentery was markedly thickened, and the ileum was edematous. Although the tumor (arrow) in the terminal ileum was partially reduced, manual reduction was unsuccessful. Ileocecal resection was performed.

Mentions: Initially, we performed probe laparoscopy, which revealed ileocolic intussusception, serous ascites and a markedly edematous ileum and mesentery (Figure 3). We then tried laparoscopic reduction of the intussusception, which resulted in failure, and therefore converted to open surgery. However, the intussusception could not be reduced, even with the Hutchinson maneuver. The mesentery was remarkably edematous, thickened and hemorrhagic. Finally, the mesentery was dissected along with intestine, and ileocecal resection with functional end-to-end anastomosis was performed. The patient’s postoperative course was uneventful, and a cytological examination of the drained ascites fluid was negative for malignancy.Figure 3


Chronic ileocolic intussusception due to transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy: a case report.

Saka R, Sasaki T, Matsuda I, Nose S, Onishi M, Fujino T, Shimomura H, Otsuka Y, Kajimoto N, Hirota S, Oue T - Springerplus (2015)

Intraoperative findings. a Ileocolic intussusception was confirmed. Laparoscopic reduction failed. b The mesentery was markedly thickened, and the ileum was edematous. Although the tumor (arrow) in the terminal ileum was partially reduced, manual reduction was unsuccessful. Ileocecal resection was performed.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508281&req=5

Fig3: Intraoperative findings. a Ileocolic intussusception was confirmed. Laparoscopic reduction failed. b The mesentery was markedly thickened, and the ileum was edematous. Although the tumor (arrow) in the terminal ileum was partially reduced, manual reduction was unsuccessful. Ileocecal resection was performed.
Mentions: Initially, we performed probe laparoscopy, which revealed ileocolic intussusception, serous ascites and a markedly edematous ileum and mesentery (Figure 3). We then tried laparoscopic reduction of the intussusception, which resulted in failure, and therefore converted to open surgery. However, the intussusception could not be reduced, even with the Hutchinson maneuver. The mesentery was remarkably edematous, thickened and hemorrhagic. Finally, the mesentery was dissected along with intestine, and ileocecal resection with functional end-to-end anastomosis was performed. The patient’s postoperative course was uneventful, and a cytological examination of the drained ascites fluid was negative for malignancy.Figure 3

Bottom Line: The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg.Since hydrostatic reduction was unsuccessful, laparotomy was performed, which showed unreducible ileocolic intussusception with a marked edematous ileum and mesentery.Ileocecal resection without lymph node dissection was carried out, and a histological examination of the resected specimen revealed the transmural infiltration of diffuse large B-cell lymphoma of the terminal ileum.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 6638501 Japan.

ABSTRACT
Chronic intussusception, defined as intussusception continuing over 14 days, is rare in children. We herein report a case of chronic ileocolic intussusception caused by the transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy. The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg. Upon admission to our hospital, ultrasonography and enhanced computed tomography (CT) of the abdomen showed ileocolic intussusception. A retrospective examination of abdominal CT led us to suspect that the intussusception had initially appeared 5 weeks before admission, presumably coinciding with the beginning of the patient's abdominal symptoms. Since hydrostatic reduction was unsuccessful, laparotomy was performed, which showed unreducible ileocolic intussusception with a marked edematous ileum and mesentery. Ileocecal resection without lymph node dissection was carried out, and a histological examination of the resected specimen revealed the transmural infiltration of diffuse large B-cell lymphoma of the terminal ileum. The patient's postoperative course was uneventful, and adjuvant chemotherapy was administered. This case illustrates the diagnostic challenges of confirming 'chronic' intussusception in older children.

No MeSH data available.


Related in: MedlinePlus