Inflammatory fibroid polyps (IFPs), or Vanek's tumor, are one of the least common benign small bowel tumors. IFP affects both sexes and all age groups, with a peak of incidence in the fifth and seventh decades. They can be found throughout the gastrointestinal tract but most commonly in the gastric antrum or ileum. The underlying cause of IFPs is still unknown. Genetic study of IFP showed mutations in platelet derived growth factor alpha in some cases. At the time of diagnosis most IFPs have a diameter of 3 to 4 cm. The lesions have always been recorded as solitary polyps. Symptoms depend on the location and the size of the lesion, including abdominal pain, vomiting, altered small bowel movements, gastrointestinal bleeding and loss of weight. IFPs arising below the Treitz ligament can present with an acute abdomen, usually due to intussusceptions. Abdominal computed tomography is currently considered the most sensitive radiological method to show the polyp or to confirm intussusceptions. Most inflammatory fibroid polyps can be removed by endoscopy. Surgery is rarely needed. Exploratory laparoscopy or laparotomy is frequently recommended as the best treatment for intussusceptions caused by IFP. The operation should be performed as early as possible in order to prevent the intussusceptions from leading to ischemia, necrosis and subsequent perforation of the invaginated bowel segment. This report aims at reviewing the diagnosis, etiology, genetics, clinical presentation, endoscopy, radiology, and best treatment of IFP.

Vanek's tumor of the small bowel in adults.

Aim: We evaluated the aetiological factors, diagnoses and treatment outcomes of adult cases of invagination of the intestine, or intussusception. We elucidated the role of ultrasonography (USG), computed tomography (CT) and other techniques in the diagnosis of such cases. Patients and Methods: Six patients with sufficient medical data, all of whom were followed-up and treated for intussusception at Safa Hospital, General Surgery Clinic, Istanbul, Turkey, between July 2008 and December 2013, were enrolled. Results: The site of intussusception was the small bowel in five cases. The aetiopathology was benign in 5 (83.3%) cases and included inflammatory fibroid polyp (IFP) and adhesion. The malignant case was adenocarcinoma. The bowel segments involved were ileoileal in five cases and ileocolic in one case. Conclusions: USG and CT aided with the diagnosis. Although more rare in adults than in children, cases of ileus presenting with acute abdominal disorder, particularly those with an uncertain diagnosis, should be considered possible intussusception cases.

Diagnosis and treatment of intestinal intussusception in adults: a rare experience for surgeons.

Aim: We evaluated the aetiological factors, diagnoses and treatment outcomes of adult cases of invagina- tion of the intestine, or intussusception. We elucidated the role of ultrasonography (USG), computed tomography (CT) and other techniques in the diagnosis of such cases. Patients and Methods: Six patients with sufficient medi - cal data, all of whom were followed-up and treated for intussusception at Safa Hospital, General Surgery Clinic, Istanbul, Turkey, between July 2008 and December 2013, were enrolled. Results: The site of intussusception was the small bowel in five cases. The aetiopathology was benign in 5 (83.3%) cases and included inflammatory fibroid polyp (IFP) and adhesion. The malignant case was adenocarcinoma. The bowel segments involved were ileoileal in five cases and ileocolic in one case. Conclusions: USG and CT aided with the diagnosis. Although more rare in adults than in children, cases of ileus presenting with acute abdominal disorder, particularly those with an uncertain diagnosis, should be considered possible intussusception cases.

https://www.ijcem.com/files/ijcem0008296.pdf

Original Article Diagnosis and treatment of intestinal intussusception in adults: a rare experience for surgeons

Gastrointestinal stromal tumor: a very rare cause of jejunoileal intussusception in a 6-year-old girl

Aim: Starting from a case presentation, this review aims to present literature data on inflammatory fibroid polyps (IFPs) of the small intestine
Methods: Case report and systematic review A comprehensive systematic review of English literature using PubMed was conducted, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines The used key words were: “inflammatory fibroid polyp” or “Vanek”, including only cases with IFPs localized of the small intestine, published from 1976 to 2019
Results: We present a case of a 38-year old patient with intestinal IFP presenting with acute abdomen due to intussusception diagnosed with ultrasound (US) based on a target sign and visible solid tumor in the small intestine leading to prompt surgical treatment A diagnosis of IFP was made based on the pathohistological findings Moreover, a systematic review of small intestine IFPs was conducted which is, to our knowledge, the first comprehensive systematic literature review on this topic The analysis included 53 case reports or case series concerning 77 cases of small bowel IFPs The patients were aged from 4 to 75 years (average 452), with a female predominance (597%) The most common localization was the ileum in 779% cases, followed by the jejunum (13%) and the duodenum (65%) The most common clinical presentation was abdominal pain due to intussusception (636%) Regarding diagnostic methods, computed tomography (CT) was frequently used as primary diagnostic method (26%) followed by exploratory laparotomy (169%), endoscopy (78%) and US (65%) Combination of US and CT contributed to the diagnosis in 91% of cases The majority of cases were treated surgically (9221%), while only a minority benefited of minimally invasive techniques such as endoscopy
Conclusions: Small bowel IFPs, ones of the least common benign tumors, are characterized by variable clinical signs and symptoms and can potentially lead to serious consequences for the patient

/pdf/inflammatory-fibroid-polyp-of-the-small-intestine-a-case-51lglytypa.pdf

Inflammatory Fibroid Polyp of the Small Intestine: A Case Report and Systematic Literature Review.

We report a case of jejunoileal intussusception in a 42-year-old patient with Crohn’s disease caused by a gastrointestinal stromal tumor. The patient complained of vague diffuse abdominal pain for a period of 4 mo. Intussusception was suspected at computer tomography and magnetic resonance imaging scans. Segmental resection of the small intestine was performed. Pathological examination of the surgical specimen revealed a gastrointestinal stromal tumor as well as aphthous ulcerations and areas of inflammation, which were characteristic of Crohn’s disease. This is the first report of small bowel intussusception due to a gastrointestinal stromal tumor coexisting with Crohn’s disease.

Gastrointestinal stromal tumor causing small bowel intussusception in a patient with Crohn's disease.

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Gastrointestinal stromal tumor causing small bowel intussusception in a patient with Crohn's disease.