Intussusception is a rare cause of intestinal obstruction in adults and is usually secondary to malignant neoplasms as the pathologic leading point. We present a case of ileocolic intussusception in an adult caused by a large pedunculated cecal lipoma and mobile cecum. The patient was a 45-year-old woman with 3 weeks’ history of colicky abdominal pain, hematochezia, and alternating bowel habits. Computed tomography of the abdomen revealed ileocolic intussusception with 75 cm low-density mass in the cecum. Right hemicolectomy was performed, and histopathological examination of the specimen confirmed the diagnosis of a subserosal cecal lipoma.
laparoscopy is recent advancing area in the field of general surgery. the identification and underlying mechanism of action of each laparoscopic instrument is necessary for their handling ans use.
understand surgical anatomy of thyroid gland by easy way very important note and you need to know it don't forget no surgery without anatomy .
dr. abdullah noor nassar
thank you
LAPAROSCOPIC HAND INSTRUMENTS, ACCESSORIES AND ERGONOMICSsinghanubhav5
EXTENSIVE COVERAGE OF LAPAROSCOPIC INSTRUMENTS AND THEIR ERGONOMICS TO HELP SURGEONS TO KNOW HOW TO USE THEIR LAP INSTRUMENTS IN MOST APPROPRIATE WAY AND THEIR ERGONOMICS TO BE COMFERTABLE DURING SURGERY AND PATIENTS LIFE ALSO MORE SAFE.
The principles of vascular repair with sutures were established in the first decade of the 20th century by Alexis Carrel, who in 1912 was awarded the Nobel Prize for medicine for his work .Since then, technical refinements of suture materials have made possible surgical reconstruction of most arteries from the root of the aorta to microvascular anastomosis or repair of the smallest vessels, e.g., digital arteries or those on the surface of the brain.
Gastric neuroendocrine carcinomas are rare and have a poor prognosis. The present case concerns with a 55 year old female who presented with complaints of recurrent vomiting on and off, hematemesis and weight loss and history of lumbar stenosis. Esophagogastroduedenostomy (EGD) showed a large ulcerated growth in the antrum. Computed tomography abdomen revealed an ill defined soft tissue density in the gastric antrum, a partial gastrectomy was performed. Microscopic evaluation revealed a neuroendocrine neoplasm. Immunohistochemically positive for Chromogranin A and Non Specific Enolase (NSE). A diagnosis of Neuroendocrine carcinoma of the stomach was given based on recent WHO classification of Neuroendocrine carcinoma of the stomach and on mitotic index with reference to grading scale.
laparoscopy is recent advancing area in the field of general surgery. the identification and underlying mechanism of action of each laparoscopic instrument is necessary for their handling ans use.
understand surgical anatomy of thyroid gland by easy way very important note and you need to know it don't forget no surgery without anatomy .
dr. abdullah noor nassar
thank you
LAPAROSCOPIC HAND INSTRUMENTS, ACCESSORIES AND ERGONOMICSsinghanubhav5
EXTENSIVE COVERAGE OF LAPAROSCOPIC INSTRUMENTS AND THEIR ERGONOMICS TO HELP SURGEONS TO KNOW HOW TO USE THEIR LAP INSTRUMENTS IN MOST APPROPRIATE WAY AND THEIR ERGONOMICS TO BE COMFERTABLE DURING SURGERY AND PATIENTS LIFE ALSO MORE SAFE.
The principles of vascular repair with sutures were established in the first decade of the 20th century by Alexis Carrel, who in 1912 was awarded the Nobel Prize for medicine for his work .Since then, technical refinements of suture materials have made possible surgical reconstruction of most arteries from the root of the aorta to microvascular anastomosis or repair of the smallest vessels, e.g., digital arteries or those on the surface of the brain.
Gastric neuroendocrine carcinomas are rare and have a poor prognosis. The present case concerns with a 55 year old female who presented with complaints of recurrent vomiting on and off, hematemesis and weight loss and history of lumbar stenosis. Esophagogastroduedenostomy (EGD) showed a large ulcerated growth in the antrum. Computed tomography abdomen revealed an ill defined soft tissue density in the gastric antrum, a partial gastrectomy was performed. Microscopic evaluation revealed a neuroendocrine neoplasm. Immunohistochemically positive for Chromogranin A and Non Specific Enolase (NSE). A diagnosis of Neuroendocrine carcinoma of the stomach was given based on recent WHO classification of Neuroendocrine carcinoma of the stomach and on mitotic index with reference to grading scale.
Cysts of the mesentery are among surgical rarities and of varied aetiology with variable presentations and
this has surgical implications in the pediatric age group. They may be derived from the gastrointestinal
tract, the genitourinary system, previous inflammation (pseudocysts) or malignant cystic tumours, but the
commonest cause is generally considered to be a congenital lymphatic cyst. The clinical presentation is not
characteristic and in addition, the preoperative imaging although suggestive is not diagnostic. In most
cases, the diagnosis is confirmed after surgical exploration and removal of the cyst. A case report of a
baby aged 6 months is being reported. Hope that this information will reinforce the diagnostic and
treatment strategy
Abstract
This case report describes the diagnosis and management of a large mesenteric cyst in a 55 year old lady who presented with abdominal distension & with mass in the left upper quadrant. Mesenteric cysts are rare, benign, abdominal tumors to which <1000 cases have been reported in the literature. While 40% of cases are incidental findings found either through physical examination or imaging, they can cause non-specific abdominal symptoms including pain, altered bowel habits, nausea/vomiting or anorexia. Less commonly, 10% of cases can present with bowel obstruction, volvulus, torsion or shock. In general, the lack of characteristic clinical and radiological features presents as a diagnostic difficulty.
The mainstay in imaging is computerized tomography (CT). CT identifies and helps aid the decision to pursue a laparoscopic or open laparotomy approach, where complete surgical resection is the ultimate goal. In our patient a CT Abdomen & Pelvis showed a large, loculated cystic mass measuring 30cm in cranio-caudal length and 16cm in the transverse and anterior/posterior diameter. While different approaches have been described in the literature to surgically resect such cysts, our approach was largely reflective of size and adherence to surrounding structures in this case. A laparotomy was performed using an upper mid-line 7 cm incision; 4500cc of fluid was aspirated from the cyst which was found to originate from the small bowel mesentery. A complete resection of the multi-loculated cystic sac was done that included the resection of the middle mesenteric vein. The post-operative period was uneventful. The patient was discharged on post-operative day 2. The Histopathology identified the mass as a multi-loculated peritoneal inclusion-type cyst.
Idiopathic Peritoneal Sclerosis: Case Presentation, And Literature Reviewsemualkaira
Most of the literature regarding peritoneal sclerosis is derived from nephrology literature surrounding peritoneal dialysis as the main and primary cause of this very rare and devastating disorder. The primary aim of this abstract is to encounter a case presentation of idiopathic peritoneal sclerosis and elaborate further on this rare condition.
Idiopathic Peritoneal Sclerosis: Case Presentation, And Literature Reviewsemualkaira
Most of the literature regarding peritoneal sclerosis is derived from nephrology literature surrounding peritoneal
dialysis as the main and primary cause of this very rare and devastating disorder. The primary aim of this abstract is to encounter
a case presentation of idiopathic peritoneal sclerosis and elaborate
further on this rare condition
Abdominal Tuberculosis Revisited–A single institutional experience of 72 case...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. SUBSEROSAL CECAL LIPOMA : A
RARE CAUSE OF ILEO-COLIC
INTUSSUSCEPTION IN ADULTS
BY
AMR BADAWY 1, AHMED SHAWKY 2, MOHAMED SHARAAN3
1. A.Lecturer , General Surgery Department, Alexandria University, Egypt.
Guest Research Associate , Graduate School Of Medicine, Kyoto University, Japan
2. Professor Of General Surgery, General Surgery Department, Alexandria University, Egypt.
3. Professor Of General Surgery, General Surgery Department, Alexandria University, Egypt
3. HISTORY
• A 45-year-old female patient presented at the
Emergency department with :
• Acute central colicky abdominal pain
• Vomiting,
• Constipation
• A single episode of bleeding per rectum.
3
4. PHYSICAL EXAMINATION
• The abdomen was slightly distended, with mild
tenderness in the right side of the abdomen.
• All Laboratory Investigations Were Normal Except :
• Mild Leucocytosis
• Hypoalbuminemia
• Hypokalemia
4
8. Provisional Diagnosis And Management
• Ileo-colic Intussusception.
• ??Colonic Or Ileal Neoplasm.
• ?? Benign Or Malignant Neoplasm
• So Exploratory Laparotomy was
performed
8
9. INTRA-OPERATIVE FINDINGS
• Ileo-colic Intussusception Partly Reduced.
• Cecal Mass
• Mobile Cecum And Part Of Ascending Colon.
• Frozen-section was not Available.
• Right Hemicolectomy ?? Malignant Tumor.
• The Surgical Specimen Pedunculated Cecal
mass about 7 X 5 cm.
9
13. INTUSSUSCEPTION
• Intussusception describes a condition in which one
segment of the intestine telescopes or invaginates
into the lumen of an adjacent segment of intestine.
• It is
• common in pediatric patients and usually
idiopathic.
• Rare in adults and usually secondary to
malignant neoplasms in up to half of
the cases.(1)
• Most neoplasm-related cases are due to
adenocarcinoma, lymphomas,
gastrointestinal stromal tumors,
metastatic melanomas, and rarely
lipomas.(2) 13
1. Varban O, Ardestani A, Azagury D, et al. Contemporary management of adult intussusception: who needs a resection? World J Surg. 2013;37:1872.
2. Rogers SO, Lee M, Stanley A (2002) Giant colonic lipoma as lead point for intermittent colo-colonic intussusception. Surgery 131:678–680
14. ADULT INTUSSUSCEPTION
• PATHOGENESIS :
The tumor may act as a foreign body
provoke abnormal peristaltic movement
leads to telescoping of one bowel segment
into the dilated distal part. (1)
In our case, mobility of the cecum and a
portion of the ascending colon played a key
role in the intussusception formation as they
were able to follow the lead point telescoping
into the distal colon.
14
1. Rogers SO, Lee M, Stanley A (2002) Giant colonic lipoma as lead point for intermittent colo-colonic
intussusception. Surgery 131:678–680
15. COLONIC LIPOMA
• Colonic Lipoma
• Rare non-epithelial neoplasms
• First described by bauer in 1757 .(1)
• Incidence : 0.2 % to 4.4 %.(2)
• More common in elderly women
• Mainly in the cecum and ascending colon.(3)
• Most of them are small in size, solitary and
asymptomatic. (3)
• 30 % of them reach 2 cm or larger in
diameter -- > may present with anemia,
constipation, bleeding, diarrhea, abdominal
pain or intussusception.(4)
• Only in 10 – 25% of cases are multiple
lesions.(5)
15
1. Ryan J, Martin JE, Pollock DJ. Fatty tumours of the large intestine: a clinicopathological review of 13 cases. Br J Surg, 1989; 76: 793-796.
2. Vecchio R, Ferrara M, Mosca F, Ignoto A, Latteri F. Lipomas of the large bowel . Eur J Surg 1996;162: 915–919.
3. Ladurner R, Mussack T, Hohenbleicher F, Folwaczny C, Siebeck M, Hallfeld K. Laparoscopic-assisted resection of giant sigmoid lipoma under colonoscopic guidance. Surg Endosc
2003;17:160.
4. Rogy MA, Mirza D, Berlakovich G, Winkelbauer F, Rauhs R. Submucous large-bowel lipomas: presentation and management. An 18-year study. Eur J Surg 1991;157:51-55.
5. Suárez Moreno RM, Hernández Ramírez DA, Madrazo Navarro M, Salazar Lozano CR, Martínez Gen R. Multiple intestinal lipomatosis. Case report. Cir Cir 2010;78:163-165.
16. COLONIC LIPOMA
• Usually arise from the submucosa and appear as sessile
polypoid masses.
• Rarely they arise from the subserosa and /or appear as
pedunculated polypoid masses.(1-2)
• Paskauskas et al. Found 37 cases of colonic lipoma
causing colonic intussusception after reviewing the
english language publications. (3)
• We found only four cases of ileocolic intussusception
caused by submucosal cecal lipoma. (4-7)
• No similar cases of subserosal cecal lipoma causing
ileocolic or colo-colic intussusception after reviewing
the english literature using pubmed .
16
1. Atmatzidis S, Chatzimavroudis G, Patsas A, et al. “Pedunculated cecal lipoma causing colo-colonic intussusception: a rare case report,” Case Reports in Surgery
2012, Article ID 279213.
2. Zhang, Xuchen, Ouyang J, Yong-Doo K. "Large ulcerated cecal lipoma mimicking malignancy." World J Gastrointest Oncol 2.7 (2010): 304-306.
3. Paškauskas, Saulius, et al. "Colonic intussusception caused by colonic lipoma: a case report." Medicina (Kaunas) 46.7 (2010): 477-481.
4. Triantopoulou, C., et al. "Adult ileocolic intussusception secondary to a submucosal cecal lipoma." Abdominal imaging 29.4 (2004): 426-428.
5. Kuzmich, Siarhei, et al. "Ileocolocolic intussusception secondary to a submucosal lipoma: An unusual cause of intermittent abdominal pain in a 62‐year‐old
woman." Journal of Clinical Ultrasound 38.1 (2010): 48-51.
6. Gys, B., Haenen F, Gys T. "Ileocolic Intussusception Caused by a Giant Ulcerating Lipoma of Bauhin’s Valve: an Unusual Cause of Intestinal Obstruction in the
Adult." Indian Journal of Surgery 77.1 (2015): 1-2.
17. DIAGNOSIS
• In Abdominal CT And MRI :
Colonic lipoma spherical or ovoid
mass with sharp margins and low
absorption densities (fat densities).(1-2)
However, intussuscepted lipomas may
have a heterogenous appearance
reflecting the degree of infarction and
fat necrosis present at the time of
radiologic evaluation. (3)
17
1. Rogy MA, Mirza D, Berlakovich G, Winkelbauer F, Rauhs R. Submucous large-bowel lipomas: presentation and management. An 18-year study. Eur J
Surg 1991;157:51-55.
2. Notaro, J. R, Masser PA. "Annular colon lipoma: a case report and review of the literature." Surgery 110.3 (1991): 570-572.
3. Buetow PC, Buck JL, Carr NJ, et al. (1996) Intussuscepted colonic lipomas: loss of fat attenuation on CT with pathologic correlation in 10 cases.
18. DIAGNOSIS
• Colonoscopy a mass covered by
normal mucosa.
• Some of endoscopic features have
been described including : (1-4)
• Tenting sign the mucosa can be
pulled up, tenting away from the mass
• Cushion sign flattening and
restoration of the shape of lipoma
18
1. De Beer RA, Shinya H. Colonic lipomas. An endoscopic analysis. Gastrointest Endosc 1975;22:90-1.
2. Michowitz M, Lazbuik N, Noy S, Lazbuik R. Lipoma of the colon. A report of 22 cases. Am Surg 1985;51:449-54.
3. Castro E, Stearns M. Lipoma of the large intestine: a review of 45 cases. Dis Colon Rectum 1972;15:441-4.
4. Messer J, Waye JD. The diagnosis of colonic lipomas – the naked fat sign. Gastrointest Endosc 1982;28:186-8.
19. MANAGEMENT
• Colonic lipoma can be resected by
either endoscopy or surgery.
• Endoscopic polypectomy is
recommended for small lipoma (<2
cm). (1)
• While colonic lipoma exceeding 2 cm
should be surgically removed.(2)
191. Jiang L, Jiang LS, Li FY, Ye H, Li N, Cheng NS, Zhou Y. Giant submucosal lipoma located in the descending colon: a case
report and review of the literature. World J Gastroenterol 2007; 13(42): 5664-7.
2. Paškauskas, Saulius, et al. "Colonic intussusception caused by colonic lipoma: a case report." Medicina (Kaunas) 46.7
(2010): 477-481.
20. MANAGEMENT
• Surgical options include
• Segmental resection,
• Colostomy with local excision,
• Hemicolectomy, or
• Subtotal colectomy
• According to the size, location of the
tumor, and presence of definite
preoperative diagnosis.(1)
20
1. Jiang L, Jiang LS, Li FY, Ye H, Li N, Cheng NS, Zhou Y. Giant submucosal lipoma located in the descending colon: a case report
and review of the literature. World J Gastroenterol 2007; 13(42): 5664-7.
21. CONCLUSION
• Intussusception in adults is
• Rare
• Usually caused by malignant
neoplasms,
• However colonic lipoma should be
considered in the differential
diagnosis.
• The high risk of bowel infarction make
intussusception a true surgical
emergency.
21
22. CONCLUSION
• CT abdomen is the investigation of choice in
the diagnosis of intussusception secondary to
colonic lipoma.
• Intraoperative frozen section is important for
doubtful cases of colonic lipoma
• Surgical approach remains the treatment of
choice for large colonic lipoma .
22
23. REFERENCE
• VARBAN O, ARDESTANI A, AZAGURY D, ET AL. CONTEMPORARY MANAGEMENT OF ADULT
INTUSSUSCEPTION: WHO NEEDS A RESECTION? WORLD J SURG. 2013;37:1872.
• GAYER G. INTUSSUSCEPTION: NOT ONLY A CHILDHOOD DISEASE. ISR MED ASSOC J 2001;3:962.
• VECCHIO R, FERRARA M, MOSCA F, IGNOTO A, LATTERI F. LIPOMAS OF THE LARGE BOWEL . EUR J SURG
1996;162: 915–919.
• LADURNER R, MUSSACK T, HOHENBLEICHER F, FOLWACZNY C, SIEBECK M, HALLFELD K. LAPAROSCOPIC-
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