An 88-year-old man presented with abdominal pain and vomiting. Contrast-enhanced computed tomography revealed a target sign, suggesting intussusception caused by a small-bowel tumor. Laparoscopic exploration was performed, followed by manual reduction using the Hutchinson technique and segmental small-bowel resection. Histopathological examination revealed a 3-cm submucosal tumor composed of pleomorphic tumor cells. Immunohistochemistry showed no specific lineage differentiation, and staining for MDM2 and CDK4 was negative. Because of his history of well-differentiated liposarcoma, metastatic disease, and dedifferentiated liposarcoma were considered. However, re-evaluation of the previous specimen showed no histological similarity to the present tumor, and the tumor was diagnosed as primary undifferentiated pleomorphic sarcoma of the small intestine. The postoperative course was uneventful, with no evidence of recurrence at the 2-year follow-up. Histological and immunohistochemical comparison is important in patients with a history of well-differentiated liposarcoma.

Wireless capsule endoscopy (WCE) uses an electronic small bowel capsule to transmit images of the small bowel to diagnose pathology. In patients at risk for capsule retention, the patency capsule, a radiopaque dissolvable capsule of the same size, may be used to predict that the small bowel capsule will pass through the patient. An abdominal radiograph or scanner is used to confirm passage of the patency capsule, predicting future passage with the small bowel capsule. If the patency capsule is retained in the small bowel, it will dissolve over time, relieving a potential obstruction. Patency capsules have been noted to be highly sensitive for detecting potential obstructing lesions and have a high negative predictive value for small bowel capsule retention. However, we describe a case and management of small bowel capsule retention occurring in a patient with a remote history of bowel resection for intussusception and normal small bowel demonstrated on CT enterography and a normal patency capsule examination.

Abdominal cocoon syndrome (ACS), also known as sclerosing encapsulating peritonitis (SEP), is a rare cause of mechanical small bowel obstruction characterized by partial or complete encasement of the small bowel within a fibrocollagenous membrane. Owing to its nonspecific clinical and radiological presentation, preoperative diagnosis remains challenging. A 38-year-old woman with a history of four previous Caesarean sections presented with one week of progressive colicky abdominal pain, abdominal distension, and absolute constipation that worsened during the preceding 24 hours despite conservative management. She reported a five-year history of recurrent, self-limiting episodes of bowel obstruction beginning two to three months after her last Caesarean section. Contrast-enhanced computed tomography (CT) was initially interpreted as a 6-cm distal jejunojejunal intussusception with a characteristic target sign. Diagnostic laparoscopy, however, revealed partial encapsulation of the small bowel by a dense fibrocollagenous membrane, consistent with secondary type I ACS. Complete laparoscopic membrane excision and adhesiolysis were successfully performed. Retrospective postoperative review of the CT images demonstrated clustering of small bowel loops with partial fibrocollagenous membrane encasement that had been overlooked on the initial interpretation. The postoperative course was uneventful. Oral intake was resumed on postoperative day 3, and the patient was discharged on postoperative day 5. Histopathological examination demonstrated fibrocollagenous tissue with chronic inflammatory infiltrates. After excluding other recognized secondary causes, the patient's history of four previous Caesarean sections was considered the most likely predisposing factor. At two-year follow-up, the patient remained asymptomatic with no recurrence of bowel obstruction. ACS may mimic intussusception on CT, creating an important diagnostic pitfall in patients with recurrent small bowel obstruction. This case highlights the importance of maintaining a high index of clinical suspicion and demonstrates the short-term technical feasibility of laparoscopic diagnosis and management in carefully selected patients when performed by experienced surgeons.

Gastroduodenal intussusception due to gastric tumours, including gastric cancer, is called ball valve syndrome. Transection of the duodenum is challenging when laparoscopic gastrectomy is performed in patients with ball valve syndrome. An 80-year-old woman with appetite loss was diagnosed with anaemia and gastric cancer and referred to our hospital. Pre-operative examination revealed two gastric cancer lesions in the antrum: one was a 20-mm elevated lesion intussuscepting into the duodenum. Laparoscopic distal gastrectomy with regional lymph node dissection was performed following the clinical diagnosis of early gastric cancer with ball valve syndrome. The prolapsed tumour was moved into the stomach using a pair of laparoscopic forceps and after confirming that the two tumours were present within the stomach using intra-operative endoscopy, the duodenum was transected and Billroth I reconstruction was performed. Gastroduodenal intussusception of small gastric cancers can be managed laparoscopically; however, intra-operative endoscopic confirmation is required to enable duodenal transection.

A retrospective observational study was conducted to determine the success rate of non-operative management of intussusception at the two major paediatric surgical referral hospitals in Kingston, Jamaica, and to compare it to previously reported regional and international benchmarks. Factors affecting the success rate and length of hospital stay were studied. Of 64 cases of radiologically confirmed intussusception among children, non-operative reduction was attempted in 40 (63%), with success in 24 (60%). Patients successfully managed non-operatively had a significantly shorter average (2.08 vs 10.88 days) and median (2 vs 5 days) lengths of stay compared with those managed surgically (p < 0.001).

Intussusception is a leading cause of intestinal obstruction in infants and young children. Non-operative reduction techniques, particularly saline hydrostatic and pneumatic methods, have significantly reduced the need for surgery. This review highlights the techniques, outcomes, and challenges associated with non-operative management of childhood intussusception in low-and middle-income countries (LMICs). A structured narrative review of the literature was conducted using PubMed, Google Scholar, AJOL, Cochrane Library, and WHO databases, focusing on studies cited in the comparative analysis of saline hydrostatic and pneumatic reduction techniques. Both prospective and retrospective studies on paediatric intussusception reporting outcomes of non-operative management were included. Articles emphasizing surgical-only approaches were excluded. Saline hydrostatic reduction under ultrasound guidance shows success rates of 60 to 90% with the advantage of being radiation-free and relatively more feasible in resource-limited settings. Pneumatic reduction has success rates of 70 to 95%, shorter procedure times, and lower complication rates, but it is constrained by the need for fluoroscopic equipment (in most settings) and trained personnel. Delayed presentation, poor health-seeking behavior, inadequate imaging facilities and shortage of trained providers remain major barriers in LMICs, contributing to morbidity and mortality. Both saline hydrostatic and pneumatic reduction are effective for non-operative management of intussusception. To improve outcomes in LMICs, there is a need for increased investment in imaging capacity, training of healthcare workers, public awareness campaigns and adoption of innovative low-cost models.

Adult intussusception is a rare cause of intestinal obstruction and is typically associated with an underlying pathological lead point. Postoperative intussusception without an identifiable lesion is particularly uncommon and may present diagnostic and therapeutic challenges. We report the case of a 44-year-old woman who developed epigastric pain, nausea, and vomiting on postoperative Day 3 following small bowel resection and enterouterine fistula excision for adhesive bowel obstruction. Contrast-enhanced abdominal computed tomography demonstrated a 20-cm ileoileal intussusception with a characteristic bowel-within-bowel appearance and no identifiable lead point. Urgent surgical re-exploration confirmed ileoileal intussusception ~60 cm proximal to the previous anastomosis. The bowel was viable, and successful manual reduction with adhesiolysis was performed without resection. This case highlights the importance of considering postoperative intussusception in adults presenting with early postoperative bowel obstruction and supports bowel-preserving management in selected patients with viable bowel and no suspicious lesion.

Background/Objectives: Intussusception is a common pediatric emergency characterized by bowel telescoping, often leading to ischemia, necrosis, and perforation if untreated. Early identification of prognostic biomarkers could improve management strategies. This study aimed to evaluate the association between admission biomarkers and treatment outcomes in children with intussusception, to identify potential predictors. Methods: A retrospective analysis was conducted on 141 pediatric patients diagnosed with intussusception over ten years. Patients were stratified into three groups based on treatment outcome: spontaneous resolution, hydrostatic reduction, or surgery. Data collected included demographic, clinical, radiological, and laboratory parameters. Results: Among the cohort, 34% experienced spontaneous resolution, 27.7% underwent hydrostatic reduction, and 38.3% required surgery. Biomarkers such as erythrocyte count, hemoglobin, hematocrit, and platelets differed significantly across groups. Multivariate analysis identified erythrocyte count, platelet count, and potassium as variables independently associated with surgical management. Lower erythrocyte counts, higher platelet counts, and lower potassium were associated with increased likelihood of surgical intervention. The erythrocyte count, platelet count, and serum potassium showed ROC AUCs of 0.64, 0.65, and 0.70, respectively. Conclusions: Admission erythrocyte count, platelet count, and serum potassium were independently associated with the need for surgery but each showed only modest standalone discrimination. They are therefore best regarded as candidate variables for multivariable or composite predictive models rather than as standalone, clinically actionable triage markers. Further prospective studies are warranted to validate their incremental value within such models.

Cronkhite-Canada syndrome is a rare, non-hereditary polyposis syndrome characterized by non-specific gastrointestinal symptoms accompanied by alopecia, cutaneous hyperpigmentation, and nail dystrophy. Characteristic endoscopic findings are diffuse sessile polypoid lesions with edematous mucosa. We report a case of a 44-year-old woman in whom intestinal ultrasound and CT revealed diffuse mucosal thickening and an ileocecal intussusception-findings that may not be pathognomonic but are highly unusual in adults. These imaging features served as critical red flags that directed the clinical suspicion toward Cronkhite-Canada syndrome and prompted timely endoscopic confirmation.

A 9-year-old neutered male Toy Poodle was diagnosed with true gastrogastric intussusception based on clinical signs, imaging studies, and endoscopic findings. The dog presented with vomiting, hematochezia, and decreased activity. Abdominal ultrasonography identified edematous thickening of the gastric wall and invagination of the gastric fundus into the gastric body. The diagnosis was confirmed by computed tomography (CT). Endoscopic examination clearly identified the intussuscepted portion of the gastric fundus, which was successfully reduced without surgery using insufflation. Histopathologic analysis of gastrointestinal biopsy samples identified chronic gastritis, enteritis, and colitis. After the procedure, the dog remained free of recurrence through day 216. This case emphasizes the value of early ultrasonographic diagnosis and successful endoscopic reduction in the management of true gastrogastric intussusception.