J Gastric Cancer.  2012 Sep;12(3):201-204.

Gastroduodenal Intussusception Resulting from Large Hyperplastic Polyp

• Kim DJ
• Lee JH
• Kim W

Abstract

Gastroduodenal intussusception is an infrequent cause of gastrointestinal obstructive disease. Benign neoplasms, gastrointestinal stromal tumors and pedunculated adenocarcinomas of less than 5 cm have been reported to cause gastroduodenal intussusception. We report a case of 76-year-old woman who was presented with a 3-day history of nausea and vomiting due to upper gastrointestinal obstruction. Computed tomography revealed gastroduodenal intussusception with the transpyloric herniation of alarge gastric hyperplastic polyp. The patient underwent laparoscopic wedge resection with the eversion method.

Keyword

Intussusception; Intestinal obstruction; Laparoscopy

MeSH Terms

Adenocarcinoma
Aged
Female
Gastrointestinal Stromal Tumors
Humans
Intestinal Obstruction
Intussusception
Laparoscopy
Nausea
Polyps
Vomiting

Figure

• 

  Fig. 1 Preoperative abdominal computed tomography images. (A) A large hyperplastic polyp that has herniated into the 2nd portion of the duodenum with peripancreatic fat infiltration. (B) Gastroduodenal intussusception with transpyloric herniation of the large gastric mass.

• 

  Fig. 2 Endoscopic finding of the 10 cm-sized large hyperplastic polyp on the anterior wall of the body.

• 

  Fig. 3 Laparoscopic wedge resection of the large gastric polyp with secure margins through the eversion technique.

• 

  Fig. 4 (A) Gross appearance of resected gastric polyp sized in 10×6 cm. (B) A histopathologic examination revealed a carcinoma in situ lesion of well-differentiated adenocarcinoma within the hyperplastic polyp including high grade dysplasia background (H&E stain, ×40).

Reference

1. White PG, Adams H, Sue-Ling HM, Webster DJ. Case report: gastroduodenal intussusception--an unusual cause of pancreatitis. Clin Radiol. 1991. 44:357–358.

2. Gyedu A, Reich SB, Hoyte-Williams PE. Gastrointestinal stromal tumour presenting acutely as gastroduodenal intussusception. Acta Chir Belg. 2011. 111:327–328.

3. Petersen JM, Felger TS, Goldstein JD. Gastroduodenal intussusception secondary to a giant brunner gland hamartoma. Gastroenterol Hepatol (N Y). 2008. 4:471–473.

4. Shum JS, Lo SS, Ka SY, Yeung CW, Ho JT. Gastroduodenal intussusception. Abdom Imaging. 2007. 32:698–700.

5. Adjepong SE, Parameswaran R, Perry A, Mathews R, Jones R, Butterworth JR, et al. Gastroduodenal intussusception due to gastrointestinal stromal tumor (GIST) treated by laparoscopic billroth II distal gastrectomy. Surg Laparosc Endosc Percutan Tech. 2006. 16:245–247.

6. Sato N, Matoba N, Kameoka N, Fujii T, Sato K, Masuda H, et al. Gastroduodenal intussusception secondary to a gastric carcinoma. Hepatogastroenterology. 1999. 46:626–628.

7. Lin F, Setya V, Signor W. Gastroduodenal intussusception secondary to a gastric lipoma: a case report and review of the literature. Am Surg. 1992. 58:772–774.

8. Asai S, Kijima H, Yamamoto S, Shiraishi S, Suzuki T, Maeda Y, et al. Gastroduodenal intussusception secondary to pedunculated gastric carcinoma. J Ultrasound Med. 2008. 27:673–676.

9. Juglard R, Rimbot A, Stéphant E, Paoletti H, Talarmin B, Arteaga C. Gastroduodenal intussusception complicating Menetrier's disease. J Radiol. 2006. 87:69–71.

10. Kang HM, Oh TH, Seo JY, Joen TJ, Seo DD, Shin WC, et al. Clinical factors predicting for neoplastic transformation of gastric hyperplastic polyps. Korean J Gastroenterol. 2011. 58:184–189.