| Small bowel intussusception due to a primary non-Hodgkin's lymphoma. An unusual presentation and clinical course. | |
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MedLine Citation:
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PMID: 20411355 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND/PURPOSE: Adult intussusception is a rare clinical entity accounting for 5% of all intussusceptions. Symptoms and signs are often vague and non-specific making a preoperative diagnosis difficult. The purpose of this study is to present a rare case of a jejuno-jejunal intussusception due to primary intestinal non-Hodgkin's lymphoma in a patient with an unusual clinical course. METHODS: A 78-year-old man presented with a 1-month history of abdominal pain, nausea, epigastric fullness, and weight loss. Computed tomography scan and ultrasonography findings were suggestive of small bowel intussusception. RESULTS: Laparotomy revealed a jejuno-jejunal intussusception caused by a primary B cell non-Hodgkin's lymphoma 20 cm distal to the ligament of Treitz. Resection without prior reduction was performed. The patient refused postoperative adjuvant chemotherapy. Seven months later, he presented with upper gastrointestinal bleeding, and the diagnostic evaluation revealed gastric infiltration of large B cell non-Hodgkin's lymphoma. Despite chemotherapy, he died of disseminated progressive disease 7 months later. CONCLUSIONS: Adult jejuno-jejunal intussusception due to primary non-Hodgkin's lymphoma is a rare clinical entity. A high index of suspicion is needed as symptoms and signs are not pathognomonic. Appropriate investigations can lead to a prompt preoperative diagnosis. Resection without prior reduction is the treatment of choice. Our patient's refusal of postoperative adjuvant chemotherapy likely resulted in relapse of the disease in another part of the gastrointestinal tract. |
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Authors:
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Nikolaos S Salemis; Evangelos Tsiambas; Christos Liatsos; Andreas Karameris; Efstathios Tsohataridis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of gastrointestinal cancer Volume: 41 ISSN: 1941-6636 ISO Abbreviation: J Gastrointest Cancer Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-10-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101479627 Medline TA: J Gastrointest Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 233-7 Citation Subset: IM |
Affiliation:
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2nd Department of Surgery, Army Veterans General Hospital, Athens, Greece. nikos_salemis@hotmail.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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