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Duodenal-Jejunal Bypass Surgery in Diet-Induced Obese Diabetic Mice

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Lipoma induced jejunojejunal intussusception.

Andreas Manouras¹, Emmanuel E Lagoudianakis, Dimitrios Dardamanis

¹1st Department of Propaedeutic Surgery, Hippocrateion Hospital, Athens Medical School, University of Athens, Q. Sophias 114, Athens 11527, Greece. amanouras@hippocratio.gr

World Journal of Gastroenterology

|July 31, 2007

Summary

Adult intussusception, though rare, often stems from structural abnormalities. This case highlights jejunojejunal intussusception caused by a lipoma, emphasizing the need for high clinical suspicion and timely surgical intervention.

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Area of Science:

Gastroenterology
Surgical Oncology
Abdominal Imaging

Background:

Intussusception is uncommon in adults, presenting with subtle symptoms that often delay diagnosis.
A significant proportion of adult intussusception cases are associated with underlying structural abnormalities, necessitating thorough investigation.
Gastrointestinal lipomas are rare benign tumors, and their role as a cause of intussusception is infrequently encountered.

Observation:

A case of jejunojejunal intussusception in an adult is presented, characterized by severe hematochezia and colicky upper abdominal pain.
Preoperative diagnosis was challenging, with computed tomography (CT) scans unable to definitively exclude malignancy.
Exploratory laparotomy was required to confirm the diagnosis of jejunojejunal intussusception.

Findings:

The intussusception was found to be secondary to a jejunal lipoma, a rare cause of this condition.
The lipoma was successfully identified as the lead point causing the intussusception.
Segmental intestinal resection was performed, leading to successful treatment of the intussusception.

Implications:

This case underscores the importance of maintaining a high index of clinical suspicion for intussusception in adults, especially with a history of gastrointestinal bleeding or pain.
Advanced imaging like CT scans can be crucial, but may not always differentiate benign from malignant causes, sometimes necessitating surgical exploration.
Surgical resection remains the definitive treatment for intussusception caused by a lipoma in adults, offering a favorable prognosis.