M A Rahim Khan, Arifa Sadaf.
Jejunal-intussusception Secondary to Leiomyoma Diagnosed on Ultrasonography.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;14(1):39-40.

A case of jejunal-intussusception is presented in which a leiomyoma acted as a lead point. The diagnosis was made on ultrasonography and appearance are described.

Case Report: 50 year old man presented at the emergency department with short history of epigastric pain associated with vomiting and constipation. On examination he was locally tender over epigastrium and provisional diagnosis of acute pancreatitis was made. Initial hematological and biochemical investigations were non-revealing. Abdominal x-ray showed double bubble sign and paucity of gas in the small bowel and the colon, indicating proximal obstruction. Ultrasonography on admission showed dilated stomach and a gut related mass in left hypochondrium giving a doughnut appearance (target sign) on transverse sections and pseudo kidney sign on longitudinal sections, features reflecting intussusception. Upper GI endoscopy confirmed the sonographic finding of gastric dilatation and 2.5 L of bile-stained fluid was aspirated with additional finding of extrinsic compression on the body of stomach. Antegrade barium study showed significant dilatation of stomach and duodenum and marked narrowing of proximal jejunum distal to DJ flexure, demonstrating a central channel with significant obstruction to the transit of contrast. In keeping with ultrasound findings, a diagnosis of intussusception of jejunum was made. At laparotomy intussusception of jejunum was found with 3.5 cm pedunculated polypoidal mass at its apex. The involved segment of jejunum with mass was resected, followed by end to end anastomosis. Histopathological examination showed leiomyomatous polyp leading to intussusception. Cystic Hydatid Disease –

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