Successful management of adult lymphoma-associated intussusception by laparoscopic reduction and appendectomy

World J Gastroenterol. 2016 May 21;22(19):4781-5. doi: 10.3748/wjg.v22.i19.4781.

Abstract

Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to life-threatening complications if left untreated or could delay chemotherapy if inappropriate surgical management is used. We report a 31-year-old man diagnosed with human immunodeficiency virus who was being treated with antiretroviral therapy. He presented with nausea, vomiting, poor appetite, and intermittent, cramping abdominal pain for over 1 wk. Abdominal computed tomography revealed a well-defined homogeneous mass in the mesenteric root region, together with a long segmental wall thickening in the ileum with ileocolic-type intussusception, which was suspected to be caused by a lymphoma. The intussusception was successfully laparoscopically reduced, and the tumor involvement of the appendix was confirmed by appendectomy with intraoperative frozen section. Systemic chemotherapy was immediately initiated after surgery without the need for bowel resection.

Keywords: Adult; Appendectomy; Intestinal lymphoma; Intussusception.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Appendectomy*
  • Biopsy
  • Chemotherapy, Adjuvant
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / diagnostic imaging
  • Colonic Neoplasms / surgery*
  • Colonoscopy
  • Humans
  • Ileal Diseases / diagnostic imaging
  • Ileal Diseases / etiology
  • Ileal Diseases / surgery*
  • Ileal Neoplasms / complications
  • Ileal Neoplasms / diagnostic imaging
  • Ileal Neoplasms / surgery*
  • Ileocecal Valve / diagnostic imaging
  • Ileocecal Valve / surgery*
  • Immunohistochemistry
  • Intussusception / diagnostic imaging
  • Intussusception / etiology
  • Intussusception / surgery*
  • Laparoscopy*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse / etiology
  • Lymphoma, Large B-Cell, Diffuse / surgery*
  • Male
  • Tomography, X-Ray Computed
  • Treatment Outcome