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Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report

INTRODUCTION: Adult intussusception is a rare condition with a pathological lead point. Intraoperative reduction of adult intussusception can eliminate the need for extensive or invasive resection. We safely performed a manual laparoscopy-assisted intraoperative reduction that allowed functional pre...

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Autores principales: Takahashi, Naoki, Narita, Kiyoshi, Sato, Rie, Suzuki, Hideo, Machishi, Hideki, Okada, Yoshikatsu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447511/
https://www.ncbi.nlm.nih.gov/pubmed/28554107
http://dx.doi.org/10.1016/j.ijscr.2017.05.010
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author Takahashi, Naoki
Narita, Kiyoshi
Sato, Rie
Suzuki, Hideo
Machishi, Hideki
Okada, Yoshikatsu
author_facet Takahashi, Naoki
Narita, Kiyoshi
Sato, Rie
Suzuki, Hideo
Machishi, Hideki
Okada, Yoshikatsu
author_sort Takahashi, Naoki
collection PubMed
description INTRODUCTION: Adult intussusception is a rare condition with a pathological lead point. Intraoperative reduction of adult intussusception can eliminate the need for extensive or invasive resection. We safely performed a manual laparoscopy-assisted intraoperative reduction that allowed functional preservation of tissue. PRESENTATION OF CASE: A 70-year-old woman with dull right lumbar pain at regular intervals and right lower quadrant abdominal tenderness was admitted to our hospital. The ileum exhibited enhanced wall thickening and invagination into the ascending colon on computed tomography. Emergency laparoscopic surgery was chosen to treat the ileocolic intussusception. First, the right colon was mobilized. Second, the ileocecal region was pulled through a 4-cm right pararectus incision. Third, the edge of the intussusceptum was gently manipulated back upstream without tearing. After reduction, a soft mass was recognized on palpation at the lead point, located 10 cm proximal to the ileocecal valve. Ileocecal resection was performed, and a laterally spreading tumor was observed in the resected specimen. The histological diagnosis was high-grade tubular adenoma. The postoperative course was uneventful. DISCUSSION: Adult intussusception has a pathological lead point, and curative treatment generally includes resection of the lesion. Complete or partial intraoperative reduction can avoid or shorten bowel resection and allow functional preservation of the tissue. CONCLUSION: Manual laparoscopy-assisted intraoperative reduction with a minilaparotomy was safely performed, which eliminated the need for extensive or invasive resection.
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spelling pubmed-54475112017-06-02 Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report Takahashi, Naoki Narita, Kiyoshi Sato, Rie Suzuki, Hideo Machishi, Hideki Okada, Yoshikatsu Int J Surg Case Rep Case Report INTRODUCTION: Adult intussusception is a rare condition with a pathological lead point. Intraoperative reduction of adult intussusception can eliminate the need for extensive or invasive resection. We safely performed a manual laparoscopy-assisted intraoperative reduction that allowed functional preservation of tissue. PRESENTATION OF CASE: A 70-year-old woman with dull right lumbar pain at regular intervals and right lower quadrant abdominal tenderness was admitted to our hospital. The ileum exhibited enhanced wall thickening and invagination into the ascending colon on computed tomography. Emergency laparoscopic surgery was chosen to treat the ileocolic intussusception. First, the right colon was mobilized. Second, the ileocecal region was pulled through a 4-cm right pararectus incision. Third, the edge of the intussusceptum was gently manipulated back upstream without tearing. After reduction, a soft mass was recognized on palpation at the lead point, located 10 cm proximal to the ileocecal valve. Ileocecal resection was performed, and a laterally spreading tumor was observed in the resected specimen. The histological diagnosis was high-grade tubular adenoma. The postoperative course was uneventful. DISCUSSION: Adult intussusception has a pathological lead point, and curative treatment generally includes resection of the lesion. Complete or partial intraoperative reduction can avoid or shorten bowel resection and allow functional preservation of the tissue. CONCLUSION: Manual laparoscopy-assisted intraoperative reduction with a minilaparotomy was safely performed, which eliminated the need for extensive or invasive resection. Elsevier 2017-05-15 /pmc/articles/PMC5447511/ /pubmed/28554107 http://dx.doi.org/10.1016/j.ijscr.2017.05.010 Text en © 2017 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Takahashi, Naoki
Narita, Kiyoshi
Sato, Rie
Suzuki, Hideo
Machishi, Hideki
Okada, Yoshikatsu
Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report
title Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report
title_full Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report
title_fullStr Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report
title_full_unstemmed Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report
title_short Manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: A case report
title_sort manual laparoscopy-assisted intraoperative reduction for adult ileocolic intussusception with ileal adenoma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447511/
https://www.ncbi.nlm.nih.gov/pubmed/28554107
http://dx.doi.org/10.1016/j.ijscr.2017.05.010
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