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      Lymphome colique révélé par invagination iléo-caecale chez l’adulte: à propos d’un cas Translated title: Colonic lymphoma revealed by ileocecal intussusception in adults: about a case

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          Abstract

          L'invagination intestinale est une affection très fréquente en pédiatrie, alors que chez l'adulte, elle reste une entité clinique rare et ne représente que 10% de l'ensemble des invaginations et 4% des occlusions intestinales. Un lymphome colique révélé par invagination intestinale est une entité très rare. Nous rapportons le cas d'une femme de 21 ans, admise aux urgences de l'hôpital Militaire Mouly Ismail à Meknes, Maroc pour une subocclusion intestinale. Le scanner abdominal a montré la présence du boudin d'invagination ainsi que la cause organique au niveau colique. La résection chirurgicale était le traitement choisi, avec un examen anatomopathologique de la pièce opératoire qui montre la présence d'un lymphome B de type diffus à grandes cellules. Après la chirurgie, une chimiothérapie est indiquée dans le but d'améliorer le pronostic et d'éviter une éventuelle rechute.

          Translated abstract

          Intussusception is a very common condition in pediatrics, while in adults it is rare and accounts for only 10% of intussusceptions and 4% of intestinal occlusions. Colonic lymphoma revealed by intussusception is a very rare disease. We report the case of a 21-year old woman admitted with intestinal subocclusion to the Emergency Department at the Military Hospital Moulay Ismail, Meknes Morocco. Abdominal CT scan showed “sausage-shaped” mass as well as its organic cause in the colon. Surgical resection was the treatment of choice, followed by anatomo-pathological examination of the surgical specimen which showed diffuse large B-cell lymphoma. After surgery, chemotherapy was indicated in order to improve the prognosis and to avoid a possible relapse.

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          Distinguishing features of self-limiting adult small-bowel intussusception identified at CT.

          To determine if clinical or computed tomographic (CT) findings can be used to distinguish self-limiting cases of adult small-bowel intussusception from those requiring surgery. Thirty-seven cases of adult small-bowel intussusception were identified by a retrospective computerized search of 69,040 abdominopelvic CT examinations performed over a 4-year period. Two independent readers recorded CT features. Clinical findings and outcomes were determined by review of all available medical records. Outcome was classified as either surgical or self-limiting. Association between predictive variables and outcome was assessed by the Fisher exact test and logistic regression models. A multivariate, stepwise, logistic regression model was used to determine the best predictors of outcome. Six patients (16%) underwent surgery, and all had lead-point tumors. Thirty-one patients were cared for conservatively (84%) and none required surgery at a mean follow-up of 5.2 months (range, 0-46 months). Multivariate, stepwise, logistic regression analysis showed intussusception length was the only variable that was independently predictive of outcome. All 20 patients with an intussusception length of 3.5 cm or less, as measured by either reader, had cases that were self-limiting. Seventeen patients had an intussusception length greater than 3.5 cm, as measured by either reader. Eleven patients had an intussusception that was self-limiting, and six patients had an intussusception that required surgery. Intussusception length is the main factor in distinguishing the majority of small-bowel intussusceptions detected at CT that are self-limiting from the minority that require surgery. An intussusception that is shorter than 3.5 cm is likely to be self-limiting.
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            Adult intussusception.

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              Paul Barbette, M.D.: a seventeenth-century Amsterdam author of best-selling textbooks.

              D Moulin (1984)
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                11 June 2018
                2018
                : 30
                : 105
                Affiliations
                [1 ]Service de Chirurgie Viscérale, Hôpital Militaire Mouly Ismail Meknes, Maroc
                Author notes
                [& ]Corresponding author: Mohamed Said Belhamidi, Service de Chirurgie Viscérale, Hôpital Militaire Mouly Ismail Meknes, Maroc
                Article
                PAMJ-30-105
                10.11604/pamj.2018.30.105.15897
                6195240
                f26c5c4b-4f73-43f2-a4e0-5fdc246f6d90
                © Mohamed Said Belhamidi et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 April 2018
                : 15 May 2018
                Categories
                Case Report

                Medicine
                invagination iléo-caecale,lymphome colique,résection chirurgicale,ileocecal intussusception,colonic lymphoma,surgical resection

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