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Adenocarcinoma of the colon occurring with intussusception in an adolescent
D Netherland1, T V Whalen, G Moore
1Department of Surgery, Naval Hospital, Portsmouth, Va.
Southern Medical Journal
|November 1, 1990
Insights
Hydrostatic reduction is a common treatment for intussusception in infants. However, older patients may have polyps or tumors, necessitating earlier surgical intervention to address the intussusception and identify the cause.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Abdominal Imaging
Background:
- Intussusception, a condition where one part of the intestine slides into another, is a common surgical emergency in infants.
- Hydrostatic reduction is the primary non-operative treatment for idiopathic intussusception in this age group.
- The etiology and optimal management of intussusception differ significantly in older children, adolescents, and adults.
Observation:
- In infants, intussusception is frequently idiopathic, responding well to hydrostatic reduction.
- In contrast, older patients presenting with intussusception often have an identifiable 'lead point,' such as a polyp or tumor.
- Delayed diagnosis or treatment in older individuals can lead to complications.
Findings:
- Hydrostatic reduction is definitive for most infant intussusception cases.
- The presence of a lead point in older patients necessitates a different management approach.
- Surgical intervention offers both therapeutic relief and diagnostic capability in these cases.
Implications:
- Early surgical consideration in older children and adults with intussusception is crucial.
- Identifying the lead point is essential for preventing recurrence and managing underlying pathology.
- This approach optimizes outcomes by addressing the intussusception and its cause simultaneously.
Abstract:
Hydrostatic reduction of intussusception is definitive therapy in most infants with this abnormality. In the older child, adolescent, and adult, a polyp or tumor is often present. Operative intervention should be considered earlier in the clinical course both to relieve the intussusception and to define the nature of the lead point.