Gastroduodenal intussusception as a rare cause of pancreatitis in a young female Ugandan: A case report

Gastroduodenal intussusception as a rare complication of gastrointestinal stromal tumor: a case report

Intussusception is a common and well-known surgical pathology. Intussusception in adults is rare, accounting for only 5% of all intussusceptions. Gastrointestinal stromal tumors (GIST) are common mesenchymal tumors of the stomach that can act as a pathological lead point for intussusception. Herein, we present an uncommon case of gastroduodenal intussusception in an elderly female patient due to gastric GIST which was successfully managed surgically by partial gastric resection. This case report creates awareness that clinicians should have gastric intussusception as their differential diagnosis for gastric outlet obstruct and highlights the importance of further radiological investigations.

Retrograde jejunoduodenogastric intussusception associated with fully functioning nonballoon nasojejunal feeding catheter: A case report

RATIONALE

Retrograde jejunoduodenogastric intussusception refers to invagination of distal small intestine into the stomach. It is extremely rare. It is often associated with displaced feeding catheter in which its balloon tip migrates past the gastric pylorus. The intussusception is triggered by retraction of migrated catheter. It is often accompanied by feeding intolerance or catheter malfunction. This report describes a distinctive case of retrograde jejunoduodenogastric intussusception associated with a fully functioning nonballoon nasojejunal tube.

PATIENT CONCERN

A 19-year-old female was presented with repeated vomiting and abdominal distension for 5 days.

DIAGNOSIS

An abdominal computerized tomography revealed retrograde jejunoduodenogastric intussusception causing air/fluid-filled gastric distension. Immediate endoscopic examination revealed a loop of small intestine, protruding through the pylorus. Progressed ischemia of the migrated small bowel loop was confirmed.

INTERVENTIONS

At laparotomy, a jejunal loop migrating into the duodenum and stomach at the level of the ligament of Treitz was noticed. After manual reduction of migrated bowel, 2 segmental resections of necrotic segment were performed. A feeding jejunostomy was constructed in the proximal jejunum.

OUTCOMES

Enteral feeding through the surgically constructed feeding jejunostomy was started on the 5th operative day and the patient was discharged on the 16th postoperative day.

LESSONS

When a patient under tube feeding exhibits abrupt intractable gastroesophageal reflux with a sign of catheter migration, we must consider the possibility of catheter-related intussusception. Having a fully functioning feeding catheter with nonballoon tip does not preclude retrograde jejunoduodenogastric intussusception.

Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor in adults: a case report and literature review

Intussusception mostly occurs in childhood and is rare in adults. Although intussusception can occur in any part of the gastrointestinal tract, gastroduodenal intussusception caused by a gastric tumor is relatively uncommon in clinical practice. A PubMed search identified 24 published cases of gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor (GIST); however, it is possible that we missed other cases not included in PubMed. Here we report a case of gastroduodenal intussusception caused by gastric GIST in an 85-year-old man. He came to the hospital because of recurrent black stools. Plain computed tomography (CT) scan indicated a mass in the gastric antrum, with slight enhancement in the arterial phase on enhanced CT scan. He was diagnosed with GIST. In addition, images indicated that the mass overlapped into the duodenum, and gastroduodenal intussusception was thus considered. Gastroscopy showed a huge mass in the gastric body. According to the gastroscopy and CT results, gastroduodenal intussusception caused by a gastric tumor was considered. The patient underwent complete surgical removal, which revealed a mass originating from the gastric antrum and overlapping into the duodenum. The postoperative pathological diagnosis was intermediate-risk gastric GIST. The patient was followed up for 4 months without tumor recurrence.