1
|
Davey MG, Conlon ET, Forde G, Byrnes VM, Carroll PA. Adult intussusception secondary to an appendiceal tumour in a patient with ulcerative colitis: a case report. Surg Case Rep 2020; 6:234. [PMID: 32990818 PMCID: PMC7524920 DOI: 10.1186/s40792-020-01017-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022] Open
Abstract
Background Intussusception in adult patients is uncommon and appendiceal lead points are particularly rare. Case presentation We present the case of a 42-year-old male with a history of ulcerative colitis, presenting with sudden onset abdominal pain and bloody diarrhoea. Endoscopy revealed grossly normal mucosa in the descending colon with a congested polypoid mass in the proximal transverse colon. Computed tomography revealed ileocecal intussusception at the hepatic flexure. A right hemicolectomy was performed, where a grossly dilated appendix was noted, resected and sent for histopathological evaluation. Results revealed low-grade appendiceal mucinous neoplasm. Post-operatively, the patient remained symptom free, however required reintroduction of biologic therapy due to relapse of his ulcerative colitis 12 weeks later. Conclusion This case depicts a rare acute surgical presentation and reminds physicians and surgeons of the importance of ‘thinking outside the box’ in clinical practice.
Collapse
Affiliation(s)
- M G Davey
- Department of Surgery, Galway University Hospitals, Galway, Ireland.
| | - E T Conlon
- School of Medicine and Health Sciences, University College Dublin, Dublin 4, Ireland
| | - G Forde
- Department of Gastroenterology and Hepatology, Galway University Hospitals, Galway, Ireland
| | - V M Byrnes
- Department of Gastroenterology and Hepatology, Galway University Hospitals, Galway, Ireland
| | - P A Carroll
- School of Medicine and Health Sciences, University College Dublin, Dublin 4, Ireland
| |
Collapse
|
2
|
Cormican S, Connaughton DM, Kennedy C, Murray S, Živná M, Kmoch S, Fennelly NK, O'Kelly P, Benson KA, Conlon ET, Cavalleri G, Foley C, Doyle B, Dorman A, Little MA, Lavin P, Kidd K, Bleyer AJ, Conlon PJ. Autosomal dominant tubulointerstitial kidney disease (ADTKD) in Ireland. Ren Fail 2020; 41:832-841. [PMID: 31509055 PMCID: PMC6746258 DOI: 10.1080/0886022x.2019.1655452] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a rare genetic cause of renal impairment resulting from mutations in the MUC1, UMOD, HNF1B, REN, and SEC61A1 genes. Neither the national or global prevalence of these diseases has been determined. We aimed to establish a database of patients with ADTKD in Ireland and report the clinical and genetic characteristics of these families. Methods: We identified patients via the Irish Kidney Gene Project and referral to the national renal genetics clinic in Beaumont Hospital who met the clinical criteria for ADTKD (chronic kidney disease, bland urinary sediment, and autosomal dominant inheritance). Eligible patients were then invited to undergo genetic testing by a variety of methods including panel-based testing, whole exome sequencing and, in five families who met the criteria for diagnosis of ADTKD but were negative for causal genetic mutations, we analyzed urinary cell smears for the presence of MUC1fs protein. Results: We studied 54 individuals from 16 families. We identified mutations in the MUC1 gene in three families, UMOD in five families, HNF1beta in two families, and the presence of abnormal MUC1 protein in urine smears in three families (one of which was previously known to carry the genetic mutation). We were unable to identify a mutation in 4 families (3 of whom also tested negative for urinary MUC1fs). Conclusions: There are 4443 people with ESRD in Ireland, 24 of whom are members of the cohort described herein. We observe that ADTKD represents at least 0.54% of Irish ESRD patients.
Collapse
Affiliation(s)
- S Cormican
- Nephrology Department, Beaumont Hospital , Dublin , Ireland
| | - D M Connaughton
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston , MA , USA.,Trinity Health Kidney Centre, Trinity Translational Medicine Institute , Dublin , Ireland
| | - C Kennedy
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - S Murray
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - M Živná
- Department of Pediatrics and Adolescent Medicine, Research Unit for Rare Diseases, First Faculty of Medicine, Charles University , Prague , Czech Republic
| | - S Kmoch
- Department of Pediatrics and Adolescent Medicine, Research Unit for Rare Diseases, First Faculty of Medicine, Charles University , Prague , Czech Republic
| | - N K Fennelly
- Pathology Department, Beaumont Hospital , Dublin , Ireland
| | - P O'Kelly
- Nephrology Department, Beaumont Hospital , Dublin , Ireland
| | - K A Benson
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - E T Conlon
- Nephrology Department, Beaumont Hospital , Dublin , Ireland
| | - G Cavalleri
- Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - C Foley
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute , Dublin , Ireland.,Clinical Research Centre, Royal College of Surgeons , Dublin , Ireland
| | - B Doyle
- Pathology Department, Beaumont Hospital , Dublin , Ireland
| | - A Dorman
- Pathology Department, Beaumont Hospital , Dublin , Ireland
| | - M A Little
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute , Dublin , Ireland.,Trinity Health Kidney Centre, Tallaght Hospital , Dublin , Ireland
| | - P Lavin
- Trinity Health Kidney Centre, Tallaght Hospital , Dublin , Ireland
| | - K Kidd
- Section on Nephrology, Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - A J Bleyer
- Section on Nephrology, Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - P J Conlon
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| |
Collapse
|