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

Crohn's disease is a chronic inflammatory disease that can involve the entire gastrointestinal tract. Several studies indicate that Crohn's patients with long disease duration have an increased risk of small bowel or colorectal cancer. In Korea, only a few cases of Crohn's disease-related small bowel or colorectal cancer have been reported. Here, we described 3 cases of colorectal cancer and 2 cases of small bowel cancer in patients with Crohn's disease. Among 5 patients, 3 had Crohn's disease-related lower gastrointestinal malignancy and the other 2 had sporadic lower gastrointestinal malignancies. Since the diagnosis of Crohn's disease-related lower gastrointestinal malignancy tends to be delayed, the development of malignancy should be considered in patients with long duration of Crohn's disease if patients have refractory symptoms despite intensive medical treatment. Surgical consultation should not be delayed.
Colorectal Neoplasms ; Crohn Disease ; Gastrointestinal Neoplasms ; Gastrointestinal Tract ; Humans ; Ileal Neoplasms ; Jejunal Neoplasms ; Korea

Linitis plastica of the colon is an uncommon presentation of primary colorectal cancer. This entity of colorectal cancer is characterized by a diffuse infiltrating tumor with desmoplastic reaction and poor prognosis. Although widespread infiltration is the main feature of linitis plastica, the tumor extending to more than 2 segments of the colon is uncommon. We report a case of primary linitis plastica involving the entire colon, ileum and appendix. The clinical characteristics are discussed with a review of literatures.
Adult ; Appendiceal Neoplasms/*pathology ; Colonic Neoplasms/*pathology ; Humans ; Ileal Neoplasms/*pathology ; Linitis Plastica/*pathology ; 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

Cystadenoma, Mucinous ; diagnosis ; pathology ; surgery ; Humans ; Ileal Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged

Malignant melanoma is the most common metastatic tumor of the gastrointestinal tract and can present with fairly common constitutional symptoms. A 36-yr-old woman was found to have a secondary malignant melanoma in the terminal ileum with profuse aneurysmal dilatation, which is not the typical presentation of the malignant melanoma in the small intestine. Radiologic studies revealed a large tumor involving the distal ileum with aneurysmal dilatations having afferent and efferent loops, which needed to be differentiated from malignant lymphoma and other gastrointestinal tumors. Exploratory laparotomy was done, and we found a huge mass with plentiful aneurysmal dilatations; much the same of the findings from the previous studies. Segmental resection with the surrounding omentum was done followed by end-to-end anastomosis between both ends of the remaining ileum. She had been free from any evidence of the local or systemic recurrence for one year after the completion of eighteen months of the subcutaneous interferon treatment; postoperatively however, the occurrence of metastatic mass at the right axilla rendered us from complete resection due to severe penetration into the vital nerves and vessels in the axilla.
Adult ; Dilatation, Pathologic ; Female ; Human ; Ileal Neoplasms/*secondary ; Ileum/*pathology ; Melanoma/*secondary ; Neoplasm Recurrence, Local/pathology ; Neoplasms, Unknown Primary/*pathology

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

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

Patients with neurofibromatosis-1 (NF-1) have increased susceptibility to a variety of malignancies. Here, we document a rare case of two separated ileal adenocarcinomas in NF-1. The adenocarcinomas were surrounded by a diffuse tubular adenomatous lesion of the mucosa, and ganglion cells were scattered in the NF background. We found this case meaningful for several reasons: two separated adenocarcinomas arising in an unusual ileal segment, the association with precancerous tubular adenoma, and the presence of ganglion cells, which suggests ganglioneuromatosis in NF-1.
Adenocarcinoma/complications/*pathology ; Adult ; Humans ; Ileal Neoplasms/complications/*pathology ; Ileum/pathology ; Intestinal Mucosa/pathology ; Male ; Neurofibromatosis 1/complications/*pathology