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Intussusception anyone?

Forums General Melanoma Community Intussusception anyone?

  • Post
    ecc26
    Participant

    I'm a stage IV patient and some of my known masses are in the abdomen, although to date none have been identified in the GI or other organs- they seem to be in abdominal lymph nodes. I had a CT last week to check the progress after being switched to the BRAF/MEK combo about 2 months ago. While I had good progress with the lymph node tumors the radiologist noted an intussusception (where a part of the intestine basically swallows itself) in my small intestine. Typically this happens when there is an abnormality (like a met or other tumor) that sort of gets sucked in during normal GI activity, but the radiologist also noted that such a "point lesion" was not seen. My understanding is that intussusceptions should never be ignored but my oncologist said it was insignificant and nothing to be concerned about.

    My questions are: has anyone else had an intussusception? If so, what were your symptoms (if any) and what was the course of action?

    My feeling was that I already have known metastatic disease and have never had evidence of an intussusception before so this is new and should be investigated (or at least followed up on) regardless of the apparent absence of a point lesion. Am I paranoid? Can intussusceptions in adults be incidental and of no significance?

    Thanks

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  • Replies
      POW
      Participant

      Several members have reported having mets in the intestines, which are apparantly hard to see on a CT scan. A few have reported an intussusception caused by a melanoma met. If you search this forum for "intusussecption" you will see several posts. I suggest that you follow up on this.   

      POW
      Participant

      Several members have reported having mets in the intestines, which are apparantly hard to see on a CT scan. A few have reported an intussusception caused by a melanoma met. If you search this forum for "intusussecption" you will see several posts. I suggest that you follow up on this.   

      POW
      Participant

      Several members have reported having mets in the intestines, which are apparantly hard to see on a CT scan. A few have reported an intussusception caused by a melanoma met. If you search this forum for "intusussecption" you will see several posts. I suggest that you follow up on this.   

      Brent Morris
      Participant

      Dear Anonymous

      Having studies done is always fraught with the danger of incidental findings, which may or may not be important. In this case the absence of a lead point is an important distinction which makes a metastatic lesion less likely. I will post the abstract. Obviously if you are symptomatic or worried you should pursue it futher with your doctor.

      Radiographics. 2006 May-Jun;26(3):733-44.

      Adult intestinal intussusception: CT appearances and identification of a causative lead point.

      Abstract

      The widespread application of computed tomography (CT) in different clinical situations has increased the detection of intussusception, particularly non-lead point intussusception, which tends to be transient. Consequently, determining the clinical significance of intussusception seen at CT poses a diagnostic challenge. Patients with intussusception may or may not be symptomatic, and symptoms can be acute, intermittent, or chronic, making clinical diagnosis difficult. In most cases, radiologists can readily make the correct diagnosis of intestinal intussusception by noting the typical bowel-within-bowel appearance at abdominal CT. However, the CT findings that help differentiate between lead point and non-lead point intussusception have not been well studied. Nevertheless, although there is considerable overlap of CT findings, when a lead mass is seen at CT as a separate and distinct entity vis-à-vis edematous bowel, it can be considered a reliable indicator of a lead point intussusception. Differentiating between lead point and non-lead point intussusception is important in determining the appropriate treatment and has the potential to reduce the prevalence of unnecessary surgery.

       

        ecc26
        Participant

        Thank you for the article

        ecc26
        Participant

        Thank you for the article

        ecc26
        Participant

        Thank you for the article

      Brent Morris
      Participant

      Dear Anonymous

      Having studies done is always fraught with the danger of incidental findings, which may or may not be important. In this case the absence of a lead point is an important distinction which makes a metastatic lesion less likely. I will post the abstract. Obviously if you are symptomatic or worried you should pursue it futher with your doctor.

      Radiographics. 2006 May-Jun;26(3):733-44.

      Adult intestinal intussusception: CT appearances and identification of a causative lead point.

      Abstract

      The widespread application of computed tomography (CT) in different clinical situations has increased the detection of intussusception, particularly non-lead point intussusception, which tends to be transient. Consequently, determining the clinical significance of intussusception seen at CT poses a diagnostic challenge. Patients with intussusception may or may not be symptomatic, and symptoms can be acute, intermittent, or chronic, making clinical diagnosis difficult. In most cases, radiologists can readily make the correct diagnosis of intestinal intussusception by noting the typical bowel-within-bowel appearance at abdominal CT. However, the CT findings that help differentiate between lead point and non-lead point intussusception have not been well studied. Nevertheless, although there is considerable overlap of CT findings, when a lead mass is seen at CT as a separate and distinct entity vis-à-vis edematous bowel, it can be considered a reliable indicator of a lead point intussusception. Differentiating between lead point and non-lead point intussusception is important in determining the appropriate treatment and has the potential to reduce the prevalence of unnecessary surgery.

       

      Brent Morris
      Participant

      Dear Anonymous

      Having studies done is always fraught with the danger of incidental findings, which may or may not be important. In this case the absence of a lead point is an important distinction which makes a metastatic lesion less likely. I will post the abstract. Obviously if you are symptomatic or worried you should pursue it futher with your doctor.

      Radiographics. 2006 May-Jun;26(3):733-44.

      Adult intestinal intussusception: CT appearances and identification of a causative lead point.

      Abstract

      The widespread application of computed tomography (CT) in different clinical situations has increased the detection of intussusception, particularly non-lead point intussusception, which tends to be transient. Consequently, determining the clinical significance of intussusception seen at CT poses a diagnostic challenge. Patients with intussusception may or may not be symptomatic, and symptoms can be acute, intermittent, or chronic, making clinical diagnosis difficult. In most cases, radiologists can readily make the correct diagnosis of intestinal intussusception by noting the typical bowel-within-bowel appearance at abdominal CT. However, the CT findings that help differentiate between lead point and non-lead point intussusception have not been well studied. Nevertheless, although there is considerable overlap of CT findings, when a lead mass is seen at CT as a separate and distinct entity vis-à-vis edematous bowel, it can be considered a reliable indicator of a lead point intussusception. Differentiating between lead point and non-lead point intussusception is important in determining the appropriate treatment and has the potential to reduce the prevalence of unnecessary surgery.

       

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