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  • Rare case of adult...

Rare case of adult intussusception caused by long intestinal tube removal

Written By : Dr Kartikeya Kohli |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-06-26T07:30:07+05:30  |  Updated On 26 Jun 2021 1:41 PM IST
Rare case of adult intussusception caused by long intestinal tube removal
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Unlike intussusception in children, the incidence of intussusception in adults is extremely low, and most of them are secondary. In previous reports, adult intussusception occurred is mostly secondary to intestinal tumors, and other causes leading to adult intussusception are rarely reported in clinic settings.

Many cases in adults are caused by tumors. Intussusception results from conditions other than tumors are uncommon. This is the first case report about intussusception that occurred after removing a long intestinal tube (LT).

A recent paper by Qiang Hu from Department of General Surgery, Tongde Hospital of Zhejiang Province, China has reported, reviewed and summarized the diagnosis and treatments of one case of adult intussusception caused by an LT removal .the findings have been published in BMC Surgery.

The authors presented a 69-year-old female who complained of "recurrent abdominal pain with reduced flatus passage and frequency of bowel movement for 10 days" was admitted to the hospital. Plain abdominal radiography and abdominal CT upon admission showed intestinal obstruction. The patient's abdominal pain was not relieved after symptomatic treatments, which involved fluid and electrolyte replacement, LT placement, spasmolytic agents, and analgesics. Hence, surgical exploration was carried out. The patient had a good recovery postoperatively.

No abdominal pain or bloating developed after food intake. The patient passed flatus and had bowel movements later. On postoperative day 9, the LT was removed. On the 10th day, the patient suddenly developed abdominal distension and acute abdominal pain. Emergency abdominal CT showed small bowel intussusception. Surgical exploration was then performed. Severe small bowel dilatation located at 1.5 m from the ligament of Treitz was found during the procedure. Intussusception at the site was observed. No color change of the intestinal wall was detected, suggesting that no necrosis was present. So, a manual reduction was done. The patient was discharged on postoperative day 6.

"This case of intussusception is due to the removal of the LT, and there is no relevant literature published at present. We hypothesized that the main causes of the intussusception, in this case, are: (1) The speed of tube withdrawal was too fast. (2) The water in the balloon of the LT was not evacuated completely.Therefore, we suggest that the following steps should be done before removing the tube: (1) During the process of removal, the speed of tube withdrawal should be slow. The tube could even be withdrawn by a section of length each day until it is completely removed. (2) Before removing the LT, the health care professional should make sure to empty the water balloon completely. The purpose of these instructions is to ensure the intestines have sufficient time to adapt to the removal process and to prevent intussusception.This case serves as a warning that the simple action of pulling out the LT might also cause serious complications, which should be given more attention."the team observed.

For full article follow the link: https://doi.org/10.1186/s12893-021-01268-2

Source: BMC Surgery

adult intussusceptioncase reportBMCLT removal
Source : BMC Surgery
Dr Kartikeya Kohli
Dr Kartikeya Kohli

    Dr Kartikeya Kohli is an Internal Medicine Consultant at Sitaram Bhartia Hospital in Delhi with super speciality training in Nephrology. He has worked with various eminent hospitals like Indraprastha Apollo Hospital, Sir Gangaram Hospital. He holds an MBBS from Kasturba Medical College Manipal, DNB Internal Medicine, Post Graduate Diploma in Clinical Research and Business Development, Fellow DNB Nephrology, MRCP and ECFMG Certification. He has been closely associated with India Medical Association South Delhi Branch and Delhi Medical Association and has been organising continuing medical education programs on their behalf from time to time. Further he has been contributing medical articles for their newsletters as well. He is also associated with electronic media and TV for conduction and presentation of health programs. He has been associated with Medical Dialogues for last 3 years and contributing articles on regular basis.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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