A rare cause of ileus in adults: İleocecal region lymphoma causes on ıntestinal obstructıon by ınvagınatıon


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Özdemir A.

3. Uluslararası 5 Ocak Uygulamalı Bilimler kongresi, Adana, Turkey, 04 January 2022, vol.1, pp.137-138

  • Publication Type: Conference Paper / Summary Text
  • Volume: 1
  • City: Adana
  • Country: Turkey
  • Page Numbers: pp.137-138
  • Recep Tayyip Erdoğan University Affiliated: Yes

Abstract

ABSTRACT

The most common site of extranodal non-Hodgkin lymphoma (NHL) is the

gastrointestinal tract. It accounts for 30-50% of all extra-nodal lymphomas. Primary

gastrointestinal lymphomas are most commonly seen in the stomach, followed by the small

intestine and colon. The most common symptom in primary gastrointestinal NHLs is

abdominal pain. B symptoms including fever, weight loss and night sweats due to lymphoma

are also very rare in these patients. In addition, obstruction or perforation is not common in

these patients, but it is known to cause an increase in mortality and morbidity rates.

Intussusception is extremely rare in older people. It constitutes approximately 5% of all

intestinal obstructions.

Our case was a 78-year-old female patient and had only hypertension in her history.

She admitted to hospital with the complaint of colic pain in the lower part of the abdomen

that continued for 3-4 days. Abdominal USG revealed an increase in wall thickness in the

localization of the cecum and ascending colon. In the physical examination, her vital signs

were stable. There was pain and tenderness in the right lower quadrant. A mass lesion was

palpated in the right lower quadrant. There was no rebound or defense. No feature was

detected on the rectal touch. There was no leukocytosis in the hemogram. CRP was 15mg/L

(0-5mg/L). The patient with high urea and creatinine values was performed CT of the entire

abdomen with oral contrast. In the CT of the patient, it was stated that there was a 50 mm

mass forming a filling defect in the filled lumen with contrast at the level of the cecum, and

that there might be an intussusception. The patient underwent colonoscopy. Due to the

presence of stool in colonoscopy, the distal hepatic flexure could not be reached. The decision

to operate was made for the patient. It was observed that a mass lesion of approximately 3-4

cm in the perioperative ileocecal valve localization and accordingly invagination of the distal

ileal segments and the cecum-ascending colon up to the hepatic flexure. In addition, there

were 1 cm lymph nodes in the intestinal meso in the ileocecal region. The patient underwent

right hemicolectomy and ileotransversostomy. The patient, whose pathology result was

reported as NHL originating from the terminal ileum, was discharged with full recovery.

In conclusion, although intussusception is a rare cause of intestinal obstruction, it often

develops secondary to a mass lesion. Although gastrointestinal malignancies are considered in

the first place, especially in elderly patients, they should be kept in mind in extranodal NHLs

as a rare cause.

Key words: bowel obstruction, intussusception, non-Hodgkin lymphoma (NHL),