Rare case of intussusception in an adult with acute myeloid leukemia

Table 1 Summary of intussusception in patients with leukemia

Number	Age/sex	Underlying leukemia	Clinical features	Imaging findings	Treatment	Clinical outcome	Ref.
1	5-yr/F	ALL	Abdominal pain, abdominal distension and constipation	X-ray showed fluid levels in bowel	Gastric suction, antibiotic therapy and supportive measures	Patient died. Autopsy showed most of the intussuscepted small bowel was gangrenous. An intramural hematoma was the leading point of the intussusceptum	Feldman et al[7]
2	7-yr/M	ALL	Abdominal distension	Not available	No surgical intervention	Patient died and intussusception was diagnosed at autopsy	Dudgeon et al[8]
3	4-yr/M	ALL	Abdominal pain, fever, vomiting and a right lower quadrant abdominal mass	Abdominal X-ray demonstrated small intestinal obstruction	At laparotomy, necrotic ileum and cecum were resected. A primary ileocolic anastomosis was performed.	Patient died with perforation of ileocolic anastomosis with peritonitis	Dudgeon et al[8]
4	14-yr/M	ALL	Vomiting, intermittent abdominal pain	Barium enema demonstrated an intussusception in descending colon reduced to ileocecal valve	Laparotomy showed a necrotic ileo-ileal intussusception. An ileal resection with primary anastomosis was performed.	Patient died with perforation of ileocolic anastomosis with peritonitis	Dudgeon et al[8]
5	11-yr/M	AML	Abdominal pain, vomiting and diarrhea	Abdominal X-ray showed air-fluid levels	Supportive treatment	Patient died of intussusception	Karakousis et al[9]
6	4-yr/F	ALL	Abdominal pain and vomiting	Not available	Resection of the involved bowel	Patient died of intussusception	Karakousis et al[9]
7	7-yr/F	ALL	Fever and colicky abdominal pain	X-ray showed dilated loops of small bowel	Surgical reduction of intussusception	Recovered from operation and continued treatment of acute leukemia	Micallef-Eynaud et al[10]
8	13-yr/F	ALL	Abdominal distension, abdominal pain, vomiting, symptoms of bowel obstruction	Barium enema showed small bowel intussusception	Surgical excision of the involved bowel	Recovered from operation and continued treatment of acute leukemia	Seckl et al[11]
9	7-mo/M	ALL	Abdominal distension, small bowel obstruction	CT scan showed small bowel obstruction	Surgical reduction of intussusception with resection of leading edge	Recovered from operation and continued chemotherapy for leukemia	Manglani et al[12]
10	8-mo/ F	ALL	Vomiting, blood and mucus in stool	Abdominal X-ray showed increased gas shadows in small intestine	Reduction of ileocolic intussusception	Recovered from operation and continued treatment of acute leukemia	Kumari et al[13]
11	3-yr/M	ALL	Abdominal pain, diarrhea, ileus	US showed thickened bowel loops with target lesion	Reduction of ileocolic intussusception	Patient died due to Escherischia coli septicemia	Gavan et al[14]
12	7-yr/F	ALL	Fever and colicky abdominal pain	X-ray showed a soft tissue mass in right iliac fossa. US revealed target lesion	Reduction of intussusception	Recovered from operation and continued treatment of acute leukemia	Arestis et al[15]
13	7-yr/F	ALL	Fever, diarrhea and colicky abdominal pain	US showed a target-shaped soft tissue mass in descending colon	Right hemicolectomy was performed	Recovered from operation and continued treatment of acute leukemia	Arestis et al[15]
14	25-yr/M	AML	Epigastric pain and vomiting, intestinal obstruction	Not available, but laparotomy was performed and a segment of thickened ileum which had led to ileo-ileal intussusception was found	Ileo-ileal intussusception was resected to relieve obstruction	Patient died of leukemia	Kini et al[4]
15	29-yr/F	AML	Right lower quadrant pain, fever, vomiting	CT scan showed that the cecum and ascending colon appeared distended and filled with loops of small bowel, and ileocecal valve was herniated into the cecum	Right hemicolectomy was performed	Recovered from operation and continued treatment of acute leukemia	Present case
16	66-yr/M	CLL	Left lower abdominal pain	US showed a large round mass in the right mid- abdomen that had alternating hypoechoic and hyperechoic rings surrounding an echogenic center (doughnut sign)	There was no surgical intervention	Patient died of leukemia	Shim et al[25]

ALL: Acute lymphoblastic leukemia; AML: Acute myeloid leukemia; CLL: Chronic lymphocytic leukemia; F: Female; M: Male; US: Ultrasound; CT: Computed tomography.