Ileo-ileal intussusception as an unusual cause of obscure overt gastrointestinal bleeding.
نویسندگان
چکیده
A 20-year-old man arrived at the emergency department with a 1-day history of melena and one episode of lipothymia. He had nomedical history andwas not taking any medication. Significant findings on physical examination included an arterial blood pressure of 90/40mmHg, paleness of his mucosae and skin, and melena on rectal digital examination. Laboratory analysis revealed normocytic normochromic anemia (6.7g/dL) and an elevated urea level (9.4mmol/L). He was treated with fluid therapy and packed red blood cell transfusion. An upper gastrointestinal endoscopy was performed, whichwas normal. A colonoscopy with terminal ileoscopy showed the presence of blood in the colon and terminal ileum,without anymucosal changes. Scintigraphywith 99mTc-pertechnetate did not show any positive findings. A capsule enteroscopy identified a large polypoid formation with congested and ulcerated mucosa in the proximal ileum (●" Fig.1; ●" Video1), which caused a delay in capsule progression. Blood traces without active bleeding were identified. The multidisciplinary team decided to perform an exploratory laparotomy. An ileal invagination in the proximal ileum was identified and a segmental enterectomywas performed (●" Fig.2). Macroscopic examination revealed an ileal invagination in the ileal lumen forming an intraluminal polypoid lesion of 7cm. Microscopic examination showed large necrotic areas and mucosal Fig.2 The resected surgical specimen showing an ileo–ileal intussusception. Fig.1 Endoscopic appearance of a large polypoid formation in the proximal ileum with congested and ulcerated mucosa. Video 1
منابع مشابه
Heterotopic Pancreas- an Unusual Cause of Ileoileal Intussusception: a Case Report
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عنوان ژورنال:
- Endoscopy
دوره 48 S 01 شماره
صفحات -
تاریخ انتشار 2016