Adult intussusception is rare, and the majority of cases has an underlying cause that requires surgical resection. We report a case of a 39 yr-old man with ileo-ileo-colic intussusception caused by ileal lipoma that was successfully managed by a laparoscopic-assisted surgical maneuver. Using a three-cannula technique, ileo-colic intussusception was reduced laparoscopically. Then, through a 4-cm transverse incision in the right lower quadrant abdomen, ileo-ileal intussusception was reduced manually, and a resection of the tumor-bearing ileal segment and end-to-end anastomosis was performed extracorporeally. Although the role of laparoscopy in managing intussusception is not clearly defined, laparoscopy may be an alternative approach to the surgical treatment of adult intussusception in selected cases.
Adult ; Case Report ; Human ; Ileal Diseases/surgery* ; Ileal Neoplasms/surgery* ; Intussusception/surgery* ; Laparoscopy ; Lipoma/surgery* ; Male

Adult intussusception secondary to primary sarcoma is a rare cause of small bowel obstruction. Only a few cases of malignant fibrous histiocytoma (MFH) of small bowel presenting as an intussusception have been reported in the literatures. We report a case of small bowel obstruction associated with jejuno-ileal intussusception caused by MFH. A 75-year-old man was admitted with an one-month history of vomiting and epigastric pain aggravated with meals. He was diagnosed as an jejuno-ileal intussusception based on CT scanning and underwent small bowel resection and anastomosis. Resected specimens revealed a polypoid tumor in the ileum and the histology of the tumor was consistent with MFH.
Aged ; English Abstract ; Histiocytoma, Fibrous/*complications/diagnosis ; Humans ; Ileal Diseases/*etiology ; Ileal Neoplasms/*complications/diagnosis ; Intussusception/*etiology ; Jejunal Diseases/*etiology ; Male

It is well known that total colonoscopy is one of the essential procedure to make diagnosis of colonic and terminal ileal diseases, to detect early atage of colonic cancer and to do prophylactic removal of premalignant polyp. Previously commonly used longer colonoscope has been reached to ileocecal area with patients much discomfort arising from excessive loop formation at sigmoid or transverse colon because of no limitation of the length. (continue...)
Colon ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Colonoscopes ; Colonoscopy ; Diagnosis ; Humans ; Ileal Diseases ; Polyps

Ileovesical fistula is a very rare clinical entity, the most frequent cause of which is Crohn's disease. Furthermore, it is an exceptionally rare complication of malignancies. We experienced one case of ileovesical fistula which had been caused by hepatocellular carcinoma (HCC) arising from the noncirrhotic liver. A 27-year-old man was diagnosed with HCC in a noncirrhotic liver. Despite treatment with transarterial chemoembolization (TACE), the disease status became more aggravated. The patient complained of dysuria, fecaluria, and intermittent lower abdominal pain. Pelvic CT scan showed a soft tissue mass of 6 cm abutting on the distal ileum which was downwardly displaced. Barium study of the small bowel showed a fistula between the small bowel loop and the urinary bladder. Upon operation, adhesion and fistula were found between the ileum and the urinary bladder. The microscopic findings of the surgical specimen were compatible with metastatic HCC. We confirmed that ileovesical fistula had been caused by metastatic HCC.
Adult ; Bladder Fistula/*etiology ; Carcinoma, Hepatocellular/*complications ; Humans ; Ileal Diseases/*etiology ; Intestinal Fistula/*etiology ; Liver Neoplasms/*complications ; Male

Usual sources of subphrenic abscess with intestinal fistula are previous abdominal operation, inflammatory bowel disease and malignancy. Reported cases of intestinal fistula caused by adenocarcinoma were complicated by direct invasion. In this report, a 70-year-old male had a subphrenic abscess with intestinal fistula and the cause was a metastatic adenocarcinoma of unknown origin. As far as we know, this has not been reported previously in the literatures. The abscess went on chronic course for six months because intermittent administration of antibiotics modified its clinical presentation. The fistulous tract between the abscess and ileum was demonstrated by tubogram via the drainage catheter in abscess. The patient underwent surgical treatment because the cause of fistula was obscure. Invasion of the ileum by metastatic adenocarcinoma was diagnosed by the histologic examination of surgical specimen. Therefore, when a fistula develops without any apparent cause, there is a possibility of malignancy, and surgical approach must be considered. An early surgical approach will prevent the delay in treatment and reduce the mortality.
Adenocarcinoma/complications/diagnosis/*secondary ; Aged ; English Abstract ; Humans ; Ileal Diseases/diagnosis/*etiology ; Ileal Neoplasms/complications/diagnosis/*secondary ; Intestinal Fistula/diagnosis/*etiology ; Male ; *Neoplasms, Unknown Primary ; Subphrenic Abscess/diagnosis/*etiology

Seven patients with giant cavernous hemangioma of the liver were treated surgically with success at Pusan Gospel Hospital, Kosin Medical College, Pusan, from 1980 through 1989. They were 3 males and 4 females, and their ages ranged from 6 to 59 years. The tumors were located on the right lobe of the liver in 5 patients and on the left lobe in 2. The lesions were solitary in all patients, and their sizes varied from 4cm to 15cm in diameter. All patients underwent hepatic resection: 1 right hepatic lobectomy and 4 partial resections for tumors on the right lobe, and 1 left lobectomy and 1 left lateral segmentectomy for tumors on the left lobe. There was no surgical death, but 1 patient had a postoperative complication: multiple stress ulcers on the stomach and ileum. The pathologic diagnosis was cavernous hemangioma in all cases. In the long-term follow-up, there was no recurrence of preoperative symptoms in any patient.
Adult ; Child ; Female ; Hemangioma, Cavernous/*surgery ; Humans ; Ileal Diseases/etiology ; Liver Neoplasms/*surgery ; Male ; Middle Aged ; Postoperative Complications/etiology ; Prognosis ; Stomach Ulcer/etiology ; Stress, Physiological/etiology ; Ulcer/etiology

OBJECTIVETo search the etiologic factor, clinical diagnosis points and treatment of postoperative intussusception (PI).

METHODSTo retrospectively review the clinical materials of 14 cases with PI including the cause of disease and treatment.

RESULTSPI occurred within 10 days (average 4 days) after the primary operation. Bowel obstructive symptoms gradually emerged. One case was diagnosed with intussusception by sonography and received enema reduction of intussusception by hydrostatic pressure. Thirteen cases were performed secondary operation. Small intestine was main site of intussusception. Manual reduction of the lesion was performed in 12 cases and bowel resection and anastomosis was done in 1 case with bowel necrosis.

CONCLUSIONPI should be suspected if child presents with the symptoms of ileus in early postoperative period. Abdominal sonography may have some value on diagnosis of PI. Operation is the first choice for the treatment of PI.

Child ; Child, Preschool ; Female ; Humans ; Ileal Diseases ; diagnosis ; etiology ; surgery ; Infant ; Intestine, Small ; surgery ; Intussusception ; diagnosis ; etiology ; surgery ; Male ; Postoperative Complications ; Retroperitoneal Neoplasms ; surgery ; Retrospective Studies ; Teratoma ; surgery

No abstract available.
Adult ; Colonic Neoplasms/diagnosis ; Colonoscopy ; Diagnosis, Differential ; Humans ; Ileal Diseases/*diagnosis/pathology ; Male ; Tomography, X-Ray Computed ; Tuberculosis, Gastrointestinal/*diagnosis/pathology

We report a rare case of giant mesenteric lipoma presenting with colicky abdominal pain. A 29-yr-old woman underwent laparoscopic resection for a giant mesenteric lipoma causing compression of the ileal loop. The resected ileal segment was encased by a giant fatty tissue, and normal mucosal fold patterns of the resected ileum were effaced by the mass. Microscopically, the mass was characterized by homogenous mature adipose tissue without cellular atypia, which was compatible with the diagnosis of a mesenteric lipoma. Despite the benign nature of this tumor, total excision with or without the affected intestinal loop should be considered if intestinal symptoms such as abdominal pain are present.
Abdominal Pain/*etiology ; Adipose Tissue/pathology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Ileal Diseases/etiology ; Laparoscopy ; Lipoma/complications/*diagnosis/surgery ; *Mesentery/pathology ; Peritoneal Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

Adult ; Endometriosis ; complications ; Female ; Humans ; Ileal Diseases ; etiology ; Intestinal Diseases ; complications ; Intestinal Perforation ; etiology