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Intussusception through an ileostomy: A case report and literature review.

ABSTRACT: Introduction:Intussusception through an ileostomy is one of the rarest complications of stomas. In this study we report a case and a brief update of the literature to focus on the clinical level of this pathology and the therapeutic attitudes. Presentation of case:a 44-year-old man who underwent a small bowel resection with double stoma for tuberculosis peritonitis presented with stomatal prolapse. On examination of the stoma, small bowel mucosa appeared to have evident rather than serosa. The patient had an elective reduction of the proximal stoma under anesthesia. Conclusion:A review of the literature shows that Intussusception through an ileostomy can occur at any time after the first surgery. The cause is still unclear. Urgent conservative surgical management based on manual reduction should be preferred.

SUBMITTER: Maatouk M

PROVIDER: S-EPMC6796582 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Intussusception through an ileostomy: A case report and literature review.

Maatouk M M Ben Safta Y Y Mabrouk Aymen A Bouafif Marwa M Hajdahmen Nesrine N Ben Dhaou Anis A Daldoul Sami S Sayari Sofien S Haouet Karim K Ben Moussa Mounir M

Annals of medicine and surgery (2012) 20190918

<h4>Introduction</h4>Intussusception through an ileostomy is one of the rarest complications of stomas. In this study we report a case and a brief update of the literature to focus on the clinical level of this pathology and the therapeutic attitudes.<h4>Presentation of case</h4>a 44-year-old man who underwent a small bowel resection with double stoma for tuberculosis peritonitis presented with stomatal prolapse. On examination of the stoma, small bowel mucosa appeared to have evident rather tha ...[more]

PMID: 31641499

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Project description:BackgroundAdult-onset colonic intussusception is a rarely encountered condition that leads to large intestinal obstruction with time. Patients often present with a variety of symptoms that are non-specific making it challenging to arrive at a definitive diagnosis. This is worrying as diagnostic delay could lead to a significant increase in morbidity and mortality. We wish to present and describe a case of an atypical endoscopic finding of colocolic intussusception secondary to ascending colon cancer.Case descriptionSixty-seven-year-old lady was referred for 1 month's duration of passing melenic stools with mucus followed by a week's complain of hematochezia. Clinical examination and other relevant blood results were unremarkable except for iron deficiency anemia. Initial colonoscopy revealed a large mass within the splenic flexure with inconclusive biopsies. A more detailed colonoscopy repeated the following day revealed a massive, black-to-yellowish lesion within the splenic flexure with no viable mucosa seen. Colonic bezoar was initially suspected, however various endoscopic retrieval methods proved futile. Switching to a slimmer diagnostic gastroscope, the colon was carefully negotiated until a large ulcer was found within the ascending colon, adjacent to the mass' origin. An emergency CT abdomen and subsequently extended right hemicolectomy performed revealed a colocolic intussusception with sealed perforation secondary to an ascending colonic mass acting as an intussusceptum. Histopathology evaluation confirmed an ascending colon adenocarcinoma (pT2N0M0) amidst a background of extensive ischemic changes.ConclusionsEndoscopic descriptions of colonic intussusception are unusual given their rarity. Furthermore, these lesions can mimic a colonic bezoar as a result of fecal accretion and this can ultimately lead to false diagnostic and therapeutic decisions. In such instances, clarification with a CT scan before management decision can potentially avert unnecessary endoscopic intervention and complications.

Dataset Information

Intussusception through an ileostomy: A case report and literature review.

Publications

Intussusception through an ileostomy: A case report and literature review.

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