Intestinal intussusception in an adult caused by helminthic parasitosis

Intestinal intussusception is an uncommon acute condition in adults and is most commonly caused by an intestinal tumor mass. Helminthic parasitosis is a widespread infection in Africa, and the load of worms is often high in individuals living in areas with inadequate sanitation. We report a case of intestinal obstruction caused by Ascaris lumbricoides infection, which was complicated by ileo-caecal intussusception and required surgical treatment in a 40-year-old Ugandan woman. This case reinforces the importance of anthelminthic prophylaxis in African rural areas

Infantile hemangioma presenting as colocolic intussusception in an infant case report with review of pathologic lead points

Infantile hemangioma (IH) is one of the most common vascular anomalies of early childhood and is usually recognized in the first few weeks to months of life as a solitary cutaneous lesion. This report documents our experience with a GLUT-1 positive IH presenting as the pathologic lead point in a colocolic intussusception in a 10-week-old infant who had no skin lesions. Literature suggests approximately 2% of all children presenting with an intussusception require surgical intervention; however, an IH as the pathologic lead point is unique

Melaena with Peutz-Jeghers syndrome: a case report

Introduction: Peutz-Jeghers syndrome (PJS) is a rare familial disorder characterised by mucocutaneous pigmentation, gastrointestinal and extragastrointestinal hamartomatous polyps and an increased risk of malignancy. Peutz-Jeghers polyps in the bowel may result in intussusception. This complication usually manifests with abdominal pain and signs of intestinal obstruction. Case Presentation: We report the case of a 24-year-old Caucasian male who presented with melaena. Pigmentation of the buccal mucosa was noted but he was pain-free and examination of the abdomen was unremarkable. Upper gastrointestinal endoscopy revealed multiple polyps. An urgent abdominal computed tomography (CT) scan revealed multiple small bowel intussusceptions. Laparotomy was undertaken on our patient, reducing the intussusceptions and removing the polyps by enterotomies. Bowel resection was not needed. Conclusion: Melaena in PJS needs to be urgently investigated through a CT scan even in the absence of abdominal pain and when clinical examination of the abdomen shows normal findings. Although rare, the underlying cause could be intussusception, which if missed could result in grave consequences

Nutritional management in a horse after caecocolic intussusception with almost total typhlectomy : a case report

A 17-year-old Haflinger gelding was referred to the Faculty of Veterinary Medicine for evaluation and treatment of acute colic. Clinical examination resulted in a presumptive diagnosis of caecocolic intussusception, which was confirmed by exploratory laparotomy. Due to severe compromise of the caecal apex wall, a partial typhlectomy was performed. Information about optimal nutritional management of typhlectomised horses is unfortunately rather limited. While immediate postsurgical support focuses on maintaining current bodyweight, the long-term goal is to obtain and maintain an optimal body condition score. In this case, postoperative nutritional support focused initially on a low-bulk diet that would be primarily digested in the small intestine, while providing sufficient fibre to provide colonocytes with an energy source. One month after surgery, a slow transition towards a more traditional diet containing long-stem roughage was made. This is the first case report describing a detailed successful nutritional approach up until six months postoperatively

Retrospective analysis of suspicious non palpable breast lesions from : the initial years of the Breast Unit in Malta

Aim: The aim of this retrospective study was to analyse the false positive rate of suspicious non palpable breast lesions detected by ultrasonography and mommography. Method: the data was collected from the first seven years (2000-2007) since the set up of the Breast Unit in Malta. Results: The results showed that the false positive rate for suspicious breast lesions detected by ultrasound and mammography were 84% and 57.6% respectively. The overall false positive rate was 62.5%. Conclusion: The overall false positive rate for suspicious breast lesions detected by both radiographic modalities is high in our unit when compared to that of other countries. Suggestions for improvement are discussed.peer-reviewe

How pharmacoepidemiology networks can manage distributed analyses to improve replicability and transparency and minimize bias

Several pharmacoepidemiology networks have been developed over the past decade that use a distributed approach, implementing the same analysis at multiple data sites, to preserve privacy and minimize data sharing. Distributed networks are efficient, by interrogating data on very large populations. The structure of these networks can also be leveraged to improve replicability, increase transparency, and reduce bias. We describe some features of distributed networks using, as examples, the Canadian Network for Observational Drug Effect Studies, the Sentinel System in the USA, and the European Research Network of Pharmacovigilance and Pharmacoepidemiology. Common protocols, analysis plans, and data models, with policies on amendments and protocol violations, are key features. These tools ensure that studies can be audited and repeated as necessary. Blinding and strict conflict of interest policies reduce the potential for bias in analyses and interpretation. These developments should improve the timeliness and accuracy of information used to support both clinical and regulatory decisions

Retrospective Surveillance for Intussusception in Children Aged Less than Five Years in a South Indian Tertiary-care Hospital

To facilitate the assessment of the safety profile of rotavirus vaccines effectively, baseline data on intussusception are important for comparison with intussusception rates following the introduction of vaccine. The aim of the study was to describe epidemiological and clinical features of intussusception in children aged less than five years in an Indian medical facility. Hospital data on intussusception for children discharged during 1 January 2001–30 June 2004 from the Christian Medical College Hospital, Vellore, India, were reviewed. Relevant information was extracted from medical records to classify cases according to the criteria of the Brighton Collaboration Intussusception Working Group. Complete review of medical records for clinical and demographic information was only performed for those cases fulfilling level 1 diagnostic certainty (definite intussusception) (Study ID 101245). During the surveillance period, 31 infants and children with definite intussusception were identified. The majority (61.2%) of the cases occurred in the first year of life. The male : female ratio was 3.4 : 1. Intussusception cases occurred round the year with no distinct seasonality. No intussusception-associated death was recorded. This study provides baseline data on intussusception in South India. Cases identified in the study were similar in presentation and demographics as those observed in other Asian settings. Prospective surveillance systems, using standardized case definitions will further increase the understanding of the aetiology and epidemiology of intussusception, especially as new rotavirus vaccines are made available

Double-site antegrade and retrograde idiopathic intussusception in an infant: a case report and review of literature

Intussusception is a very common surgical problem in infants. Double intussusception, however, is very rare in children. The authors report the successful management of a case of double-site antegrade and retrograde idiopathic intussusception in an 11-month-old boy.Keywords: antegrade, double-site intussusception, idiopathic, retrograd