Potential Therapeutic Approaches for the Intussusception Through a Side-to-Side Jejunojejunal Anastomosis After Laparoscopic Gastrectomy
We reviewed our experience with the management of intussusception presenting as a complication of laparoscopic gastrectomy (LG) and studied the feasibility of a laparoscopic intervention to treat or prevent this condition. We retrospectively analyzed the data of 12 patients diagnosed with intussusception, following gastrectomy, from 2008 to 2017, including clinical manifestations, incidence, post-LG time-interval before diagnosis, and treatment. Totally, 12/2300 gastrectomy patients (0.52%) developed intussusception. All 12 had undergone laparoscopic distal gastrectomy for gastric cancer (12/1250, 0.96%) and presented with intussusception through a side-to-side jejunojejunal anastomosis. The mean latency period was 423.8 (range: 86 to 1500) days. Four patients underwent emergent laparoscopic reduction of the efferent loop without bowel resection, along with fixation of the reduced jejunum to the afferent loop and the small bowel mesentery, to prevent a recurrence. One patient required open surgery with manual reduction and segmental resection of the gangrenous small bowel portion. All operated patients recovered without any complications. Intussusception resolved spontaneously in the remaining 7/12 patients. We found that a laparoscopic approach can be used for preventing or managing post-LG intussusception. We found that recurrence can be prevented or treated by anchoring and fixing the (reduced) efferent loop to the afferent loop and the small bowel mesentery.
Publication date: Available online 1 June 2020Source: MethodsAuthor(s): Reyhaneh Manafi-Farid, Najme Karamzade-Ziarati, Reza Vali, Felix M. Mottaghy, Mohsen Beheshti
Publication date: Available online 2 June 2020Source: Biochimica et Biophysica Acta (BBA) - Molecular Cell ResearchAuthor(s): Dipanwita Das Mukherjee, N. Maruthi Kumar, Mukund P. Tantak, Satabdi Datta, Debabrata Ghosh Dastidar, Dalip Kumar, Gopal Chakrabarti
This study was carried out in accordance with approval of the Melbourne Health and Walter and Eliza Hall Institute of Medical Research's Human Research Ethics Committee (approval number: 2013.081). All subjects gave written informed consent for participation and publication. Results and Discussion TGF-β signaling in NK cells is associated with: phosphorylation in SMAD2 and 3, inhibition of IL-15-induced metabolism/proliferation, simultaneous downregulation of CD44, CD49e, and Eomes, and upregulation of CD16 and CD49a expression (7, 10). SMAD family member 4 (SMAD4) belongs to the SMAD family of transcription...
Discussion In this section, we discuss the mechanisms responsible for lymphomagenesis in the various inborn errors of immunity and provide an overview of the treatment. Defects in Immune Responses That Predispose to Lymphomagenesis in PIDDs The complex immune mechanisms and their interplay that predisposes to neoplastic transformation of B or T cells and development of lymphomas in PIDD patients has not been fully elucidated. However, it is expected that the etiology in most cases is multifactorial and related to a dynamic regulation of immune response and environmental triggers (Figure 3). An underlying intrinsic susce...
CONCLUSION Jejunogastric intussusceptions after distal gastrectomy is a rare complication; however, when it occurs, early diagnosis and appropriate management are necessary.
CONCLUSION Jejunogastric intussusception and bile duct stones are rare after distal gastrectomy, physicians should be alerted to the possibility of these complications.
Conclusion Maintaining a high index of suspicion is paramount in early diagnosis and treatment of this condition, which is associated with high mortality rates if surgery is delayed.
In this report, we present the unique findings of a case of gastroduodenal intussusception caused by an underlying gastric GIST and complicated with severe acute pancreatitis. PMID: 27104028 [PubMed]
Dinesh Pradhan, Neeraj Kaur, Birinder NagiJournal of Cancer Research and Therapeutics 2015 11(4):1031-1031Small bowel intussusception is an uncommon condition with cases of duodenoduodenal intussusception (DDI) being exceptionally rare. Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, etiology, and treatment. DDI is very unusual due to the fixed position of the duodenum within the retroperitoneum. The lead point usually is hamartomatous polyp, adenoma, or adenocarcinoma. Only few cases of DDI in adults have been reported in the literature. We herein report a series o...
A 42-year-old man, receiving palliative treatment for lung cancer, presented with hyperemesis, abdominal pain, and intestinal subocclusion. Endoscopy showed a large volume of liquid stasis and gastric lesions compatible with metastasis (Video 1, available at www.giejournal.org). Computed tomography revealed intussusception in the jejunal loop. Single-balloon endoscopy demonstrated multiple metastatic lesions throughout the small bowel. At the midjejunum level, a 5-cm vegetative lesion was found, which partially prevented the endoscope transposition.