Akademik Veri Yönetim Sistemi
3. Uluslararası 5 Ocak Uygulamalı Bilimler kongresi, Adana, Türkiye, 04 Ocak 2022, cilt.1, ss.137-138
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),