Dear Label_Name,

Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
American Journal of Public Health Research
American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
Journal of Biomedical Engineering and Technology
American Journal of Microbiological Research
Biomedical Science and Engineering

We are pleased to announce that submissions are now being accepted for peer review for all the journals across all our subject areas in SciEP.

Please submit your manuscript via our online submission system:
http://www.sciepub.com/author/signin

To unsubscribe from our mailing list, please click on the following link: unsubscribe

I am looking forward to hearing from you.

Kind regards,

David Rain
Email:join@sciepub.com
Science and Education Publishing (http://www.sciepub.com)

Inflammatory Fibroid Polyp Presenting as Ileo-colic Intussusception: A Case Report and Review of Literature

Sutrave Tarun, Tanweerul Huda, Merlyn S. Henriques, Jason Golmei, Bharati Pandya*

Department of General Surgery, All India Institute of Medical Sciences, Bhopal, India

Abstract: AIM: To provide a brief review of literature on intussusception due to inflammatory fibroid polyp (IFP). METHODS: A case report on inflammatory fibroid polyp presenting as ileo-colic intussusception made us review the literature on IFPs presenting as Intussusception, published in PubMed in English language. A comprehensive search of all case reports was done using keywords: intussusception due to IFP, intussusception and IFP, intussusception, IFP. The search covered all case reports from 2000 to 2020. RESULTS: 53 case reports with a total of 55 cases were analysed in this article, the range of age with such a presentation was from minimum10 years to maximum 79 yrs age, with median age of presentation 48years. 22 cases were males and 32 females, with one case gender not specified. Most common site of IFP presenting as intussusception was ileum (43cases), leading to ileo-colic intussusceptions, there were 11 case reports of jejunal intussusceptions also.

Keywords: Inflammatory fibroid Polyp (IFP), Ileocolic Intussusception, Inflammatory myo-fibroblastic tumours (IMT)

Received April 15, 2020; Revised May 17, 2020; Accepted May 24, 2020

Citation: Sutrave Tarun, Tanweerul Huda, Merlyn S. Henriques, Jason Golmei, Bharati Pandya, Inflammatory Fibroid Polyp Presenting as Ileo-colic Intussusception: A Case Report and Review of Literature. Global Journal of Surgery, 8 (1). 4-10. January 2020. doi:10.12691/js-8-1-2

1. Introduction

Intussusception is the prolapse of a portion of the intestine into an immediately adjacent portion [1]. It is the frequent cause of intestinal obstruction in infants and infrequent among adults with 2 to 3 cases occurring in a population of 1,000,000 per annum [2], accounting for less than 0.1% of all hospital admissions in adults [2]. The lead point associated with intussusception in small bowel could be a benign [70%] or a malignant lesion [30%], whereas in large bowel the lead point is usually a malignant lesion [66%] rather than benign [3]. Here we describe an adult female presenting to the emergency department with symptoms of sub-acute intestinal obstruction [SAIO] due to ileo-colic intussusception with a rare benign neoplastic lead point, an Inflammatory Fibroid Polyp (IFPs).

Inflammatory fibroid polyps are uncommon benign mesenchymal tumours of the gastrointestinal tract with histological resemblance with inflammatory myo-fibroblastic tumours (IMFTs) and consist of spindle shaped stromal elements with inflammatory infiltrate of eosinophils. Historically both were considered the same and IFPs were thought to be gastro-intestinal manifestations of IMFTs [4] Based on extensive studies, both the entities have been now distinguished and many authors consider them as separate entities under the classification of mesenchymal tumours. Because of slightly different biological properties their clinical outcomes vary. IMFTs are known to recur, unlike the IFPs. IFPs have overlapping features with the most common mesenchymal tumor of gastro-intestinal tract, the GIST [5]. IFPs tend to have activating PDGFRA mutations, having molecular overlap with GIST, but lack GIST specific tumor markers DOG-1 or c-KIT; however, both express CD34 [6]. Immunohistochemical staining of IFPs for PDGFRA supports the diagnosis of an inflammatory fibroid polyp [7].

2. Material and Methods

A case report of 70-year-old, female with inflammatory fibroid polyp presenting as ileo-colic intussusception is discussed. Review of literature on ‘IFPs presenting as Intussusception’, was conducted from database of PubMed. A comprehensive search of all case reports in English language was done using keywords: intussusception due to IFP, intussusception and IFP, intussusception, IFP. The search covered all case reports from January 2000 to March 2020. Articles with sufficient information on age, sex, duration of complaints, diagnostic tool, surgical intervention, site of tumor, and tumor size were taken for review, Inadequate articles with missing information were excluded from the study.

3. Case Report

A 70-year-old, female, presented with complaints of intermittent colicky abdominal pain in the umbilical region of 6 months duration, associated with recurrent episodes of nausea and vomiting. There was history of obstipation during the episodes of pain. Her past medical and family history was insignificant. The general physical examination and abdominal examination were otherwise normal, except for mild tenderness and a vague mass in the right iliac fossa.

Figure 1. CECT Abdomen showing Ileocolic intussusception

On investigating, her routine investigations tested normal. The abdominal X-ray revealed non-specific air-fluid levels. Ultrasound abdomen revealed dilated small bowel loops with caecal thickening. The contrast-enhanced computed tomography (CECT) scan of the abdomen revealed an ileo-colic intussusception of 7cm length with heterogeneously enhancing mass of size 4.2 x 3.2 x 3.6cm arising from the lead point of intussusception and a few sub-centimetric homogenously enhancing lymph nodes around the ileo-caecal region (Figure 1). The appendix was distinctly visualized on the CT scan.

After an informed consent patient underwent a midline exploratory laparotomy and was found to have an ileo-colic intussusception (Figure 2), (Figure 3). The healthy appendix and the caecum were clearly seen before the reduction of the intussusception (Figure 4). Standard right hemicolectomy with side to side ileo-transverse anastomosis was performed in view of her age, the mass and enlarged mesenteric lymph-nodes on CT scan wherein the possibility of malignancy could not be ruled out.

Figure 2. Intraoperative picture showing the ileocolic intussusception with normal appendix lying adjacent but not intussuscepting

Figure 3. Resected specimen showing the ileo-colic intussusception

Figure 4. Resected specimen after reduction with the mass and after cutting open the ileum

Figure 5. Focal surface ulceration and submucosal growth is seen. The underlying stroma is composed of loosely dispersed fibroblastic proliferation having spindle to stellate shape, imperceptible cytoplasm, bland nuclear features and focal reactive atypia. Interspersed are numerous plasma cells, mast cells, lymphocytes, and eosinophils. Presence of thin and thick-walled vessels are seen within the lesion. No necrosis, atypia, or increase in mitosis is noted. Histopathology is suggestive of IFP

On macroscopic examination of the gross excised specimen, the serosal surface was unremarkable; on cutting it open, the lumen of small intestine showed a protruding polypoidal mass of size 4x3.5x2.5cm. Microscopic examination showed a polypoidal growth with focal surface ulceration arising from the submucosal location. Underlying stroma showed loosely dispersed fibroblastic proliferation having spindle to stellate shaped cells, interspersed with numerous inflammatory cells suggestive of inflammatory fibroid polyp (Figure 5). The IHC markers were supportive of the diagnosis. Patient had an uneventful postoperative recovery. She was kept under follow-up. There has been no recurrence in the last one year.

4. Literature Review

Extensive search of all published articles in PubMed from year 2000 to March 2020 was done. A total of 53 case reports with a total of 55 cases were included for the review. On descriptive analysis of the data, the range of age with such presentation was from 10 years minimum to maximum of 79 years, with median age of 48 years. 22 were males and 32 females, in one case gender was not specified. Most common site of IFP presenting as intussusception was at ileum (43cases), leading to ileo-colic intussusception, there were few, only 11 case reports of jejunal intussusceptions. Individualities of all cases is briefed in Table 1.

Table 1.

5. Discussion

Adult intussusception is an infrequent finding and a rare cause of bowel obstruction accounting for only 5% of bowel obstructions [8]. Intussusception, itself being pathological is associated with a lead point. It could be primary or idiopathic without any lead point. Idiopathic intussusception is common in children. In adults, 20% of intussusception is idiopathic [2]. Intussusception is also classified based on the location of its occurrence as intussusception within small bowel [entero-enteric], terminal ileum telescoping into colon [ileocolic], ileocecal valve as lead point telescoping into colon [ileocecal] and in large bowel [colo-colic]. In a large case series described by Brayton et al of 745 adult patients operated for intussusception, small bowel was the most common site, 52% small intestinal origin (95 patients ileocolic + 294 entero-enteric), 38% colonic origin (124 ileo-caecal + 31 appendico-caecal + 130 colo-colic), 4% stomal (in 30 patients), 6% gastric and duodenal (in 45 patients) [9].

Intussusception can be also classified based on its cause as benign, malignant, or idiopathic (primary). In adults, the precise mechanism of bowel intussusception is ill-defined (primary or idiopathic) in 8%-20% of cases and in such, is more likely to be entero-enteric [8,10]. Patho-physiological mechanism of secondary intussusception is understood to be initiated from irritant within the lumen that changes normal peristaltic activity leading to intussusception or any structural lesion in the bowel wall that acts as a lead point, leading to telescoping of one segment of the bowel into another along with the mesentery of the proximal segment, causing bowel obstruction and compromised blood supply to the proximal segment, which initiates inflammatory bowel changes causing thickening of the bowel wall to ischemic necrosis [11]. 70% of lead points in the small bowel are benign lesions that are mostly intraluminal like adenomatous polyp, submucosal lipomas, leiomyomas, hamartomas, diverticulum, rarely inflammatory lesions like inflammatory fibroid polyp [12,13]. Benign etiology, without lead points can also lead to transient intussusception in conditions like celiac sprue and Crohn’s disease [13]. Malignant lead points could be lymphomas, Adenocarcinomas(most common in colon), metastases (most common in small bowel] [14]. In large bowel the lead point is often malignant (66%) [3].

Inflammatory fibroid polyps (IFPs) are uncommon benign lesions. It was first described in stomach as gastric submucosal granuloma with eosinophilic infiltrate by Vanek in 1949 [15]. Known by terminologies like Vanek’s tumor, polypoid myo-endothelioma, eosinophilic granuloma, fibroma with eosinophilic infiltration [15], it involves both sexes equally and the peak age of incidence is 5th to 7th decade of life [16]. Many theories have been proposed to explain the inflammatory growth, the most accepted one being the benign reactive growth in response to an unidentified irritant [16]. Suspected irritants that need yet to be proved are H. pylori, parasite, and foreign body [16]. The latest theory includes mutations in PDGFRA as reports of familial occurrence have also been reported [17]. The commonest site of IFPs is gastric antrum (60-70%), followed by small bowel (18-20%) and colo-rectum (4-7%), and least common (1%) is oesophagus, duodenum, gallbladder, and appendix [18]. Meta-chronicity in IFPS is rare and is seen in familial cases [17].Gross Size of IFPs at the time of diagnosis usually is 3 - 4cm, with a size ranging from 0.4 - 30cm [7].

Depending on the site of Inflammatory fibroid polyps, the clinical presentation varies. The majority of IFPs are incidental findings detected endoscopically and during laparotomy [19]. They are asymptomatic and rarely present with anaemia, chronic pain abdomen and intussusception [20]. Intussusception and obstruction are the most common presentation of IFPs of small bowel origin [9]. The Intussusception triad of palpable abdominal mass with pain abdomen and bloody diarrhoea is rare in adults but more common in children as an acute presentation. Adult intussusceptions are usually chronic with signs and symptoms of partial to complete bowel obstruction with or without GI bleeding [21]. IFPs are benign but can present with a lower GI bleed. Malignant lead points are more likely to be hemoccult-positive stools.

Since the patient presents with features of intestinal obstruction the initial diagnostic modality is plain abdominal X-ray and USG whole abdomen. Plain X-ray features suggest intestinal obstruction and the probable site of obstruction [69]. Contrast studies demonstrate ‘coil spring’ appearance in upper GI study and ‘cup-shaped’ filling defects in patients with colic intussusceptions on barium enema examinations [70,71]. Ultrasonography is a useful imaging tool in diagnosing intussusception in both adults and children [72] especially in emergency. USG features in intussusception are doughnut or target sign in transverse view and pseudo-kidney sign in longitudinal view [73]. The most sensitive imaging modality to diagnose intussusception however, is CECT with diagnostic accuracy as high as 58% to 100% [74]. Imaging signs include target sign, mesenteric vessels within the bowel lumen [74]. Nevertheless, the visibility of mass within intussusception is poor [75].

The management of IFPs is based on its location and presentation. Asymptomatic IFPs located in the stomach, duodenum, and colon can even be resected endoscopically [76]. If IFPs are complicated with intussusception it warrants surgical intervention to avoid the fear of bowel ischemia and necrosis. If intraoperative features are suggestive of a benign lesion, reduction and limited resection of small bowel intussusception is advised instead of en-bloc resection of the intussuscepted segment of bowel as in colonic intussusception [77]. Since colonic intussusception is more commonly associated with malignant lead points, which on bowel handling leads to perforation and seeding of tumor cells into the abdominal cavity, hence a wide resection is preferred [77].

Histologically, an inflammatory fibroid polyp has a characteristic localized proliferation of mononuclear spindle-shaped cells with an inflammatory infiltrate [16]. IFPs arise from submucosal layer and extend outside to muscularis propria and inner mucosa [7]. IFPs are very well demarcated from surrounding normal tissue and are unencapsulated tumours [7]. They predominantly have eosinophils infiltrate and more fibrosis when compared to IMFTs. Spindle shaped cells are loosely dispersed in a fibro-myxoid stroma with a prominent regular vascular network [4]. Whereas IMFTs occurs mostly in young age, and have a tendency to infiltrate, more cellular with a fascicular architecture and a poor vascular network [4]. Both appear to be benign processes.

Immunohistochemically, IFPs show inconsistent positivity for CD34 and negativity for CD117 and S100 protein [16], whereas IMFTs are always CD34 negative. Positive CD34 suggests primitive perivascular or vascular cell origin [20]. IFPs are differentiated from GIST as IFPs is CD117 negative and they have no risk of recurrence or metastasis after removal. Other differentials of IFPs include plexiform fibro-myxoma and smooth muscle tumours. Plexiform fibro-myxoma contains spindle cells in fibro-myxoid stroma but lack the characteristic eosinophilic inflammatory infiltrate and are CD34 negative [7]. Smooth muscle tumours exhibit desmin, SMA and caldesmon, and are CD34 negative [7]. Most of gastric and small bowel IFPs have expression of PDGFRA (100% of gastric IFP and 95% of small bowel IFP) [5]. Immunohistochemical staining for PDGFRA may be useful to support a diagnosis of inflammatory fibroid polyp.

6. Conclusion

In conclusion, IFPs are rare benign mesenchymal tumours of the GI tract with resemblance to inflammatory myo-fibroblastic tumours IMFTs. Immunohistochemical staining may be useful to support a diagnosis of inflammatory fibroid polyps in case of diagnostic dilemma. Being a benign tumor management guidelines have not been standardized. In case of small bowel IFPs where diagnosis is not possible with preoperative biopsy, or when the presentation is in emergency, management is always limited resection and anastomosis. In other sites if preoperative diagnosis of IFPs is made and growth is small and asymptomatic, management of vigilant wait vs early resection is yet to be studied. IFPs are known to cause lower GI bleed and further complicate with intussusception and obstruction. Therefore, early resection is a better option than vigilant wait. No reports of recurrence of IFPs have been documented till date. Hence, no follow-up protocol guidelines have been established.

Declarations

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required.

References

[1]   | Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood Intussusception: A Literature Review. Cameron DW, editor. PLoS ONE. 2013 Jul 22; 8(7): e68482.
[2]   | Yalamarthi S. Adult intussusception: case reports and review of literature. Postgraduate Medical Journal. 2005 Mar 1; 81(953): 174-7.
[3]   | Yakan S, Calıskan C, Makay O, Deneclı AG, Korkut MA. Intussusception in adults: Clinical characteristics, diagnosis and operative strategies. WJG. 2009; 15(16): 1985.
[4]   | Makhlouf HR, Sobin LH. Inflammatory myofibroblastic tumors (inflammatory pseudotumors) of the gastrointestinal tract: How closely are they related to inflammatory fibroid polyps? Human Pathology. 2002 Mar; 33(3): 307-15.
[5]   | Plesec TP. Gastrointestinal Mesenchymal Neoplasms other than Gastrointestinal Stromal Tumors: Focusing on Their Molecular Aspects. Pathology Research International. 2011 Feb 16; 2011: 1-10.
[6]   | Huss S, Wardelmann E, Goltz D, Binot E, Hartmann W, Merkelbach-Bruse S, et al. Activating PDGFRA mutations in inflammatory fibroid polyps occur in exons 12, 14 and 18 and are associated with tumour localization: PDGFRA mutations in IFP. Histopathology. 2012 Jul; 61(1): 59-68.
[7]   | Doyle LA, Hornick JL. Mesenchymal Tumors of the Gastrointestinal Tract Other than GIST. Surgical Pathology Clinics. 2013 Sep; 6(3): 425-73.
[8]   | Begos DG, Sandor A, Modlin IM. The diagnosis and management of adult intussusception. The American Journal of Surgery. 1997 Feb; 173(2): 88-94.
[9]   | Brayton D, Norris WJ. Intussusception in adults. The American Journal of Surgery. 1954 Jul 1; 88(1): 32-43.
[10]   | Erkan N, Hacıyanlı M, Yıldırım M, Sayhan H, Vardar E, Polat AF. Intussusception in adults: an unusual and challenging condition for surgeons. Int J Colorectal Dis. 2005 Sep; 20(5): 452-6.
[11]   | Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, et al. The Diagnosis and Treatment of Adult Intussusception: Journal of Clinical Gastroenterology. 2003 Jan; 36(1): 18-21.
[12]   | Marinis A, Yiallourou A, Samanides L, Dafnios N, Anastasopoulos G, Vassiliou I, et al. Intussusception of the bowel in adults: A review. WJG. 2009; 15(4): 407.
[13]   | Choi YS, Suh JP, Lee IT, Kim JK, Lee SH, Cho KR, et al. Regression of giant pseudopolyps in inflammatory bowel disease. Journal of Crohn’s and Colitis. 2012 Mar; 6(2): 240-3.
[14]   | Barussaud M, Regenet N, Briennon X, de Kerviler B, Pessaux P, Kohneh-Sharhi N, et al. Clinical spectrum and surgical approach of adult intussusceptions: a multicentric study. Int J Colorectal Dis. 2006 Dec; 21(8): 834-9.
[15]   | Vanek J. GASTRIC SUBMUCOSAL GRANULOMA WITH EOSINOPHILIC INFILTRATION. 15.
[16]   | Wysocki AP, Taylor G, Windsor JA. Inflammatory Fibroid Polyps of the Duodenum: A Review of the Literature. Dig Surg. 2007; 24(3): 162-8.
[17]   | Siminas S, Qasem E, Shukla R, Turnock R. Inflammatory Fibroid Polyp: A Rare Benign Tumor of the Alimentary Tract in Children Presenting As Intussusception—Case Report and Review of Literature. Eur Jnl Ped Surg Reports. 2013 Sep 9; 02(01): 016-9.
[18]   | Akbulut S. Intussusception due to inflammatory fibroid polyp: A case report and comprehensive literature review. WJG. 2012; 18(40): 5745.
[19]   | Rehman S, Gamie Z, Wilson TR, Coup A, Kaur G. Inflammatory fibroid polyp (Vanek’s tumour), an unusual large polyp of the jejunum: a case report. Cases J. 2009; 2(1): 7152.
[20]   | Nonose R, Valenciano JS, da Silva CMG, de Souza CAF, Martinez CAR. Ileal Intussusception Caused by Vanek’s Tumor: A Case Report. Case Rep Gastroenterol. 2011; 5(1): 110-6.
[21]   | Martin-Lorenzo JG, Torralba-Martinez A, Liron-Ruiz R, Flores-Pastor B, Miguel-Perello J, Aguilar-Jimenez J, et al. Intestinal invagination in adults: preoperative diagnosis and management. International Journal of Colorectal Disease. 2004 Jan 1; 19(1): 68-72.
[22]   | Park KB, Jee YS, Kim D-W. Laparoscopic resection of two inflammatory fibroid polyps: An unusual cause of jejunojejunal intussusception. Int J Surg Case Rep. 2020 Mar 28; 69: 20-3.
[23]   | Karuhanga T, Ngimba C, Yahaya JJ. Inflammatory Fibroid Polyp in a 48-Year-Old Male: A Rare Cause of Intussusception. Case Rep Surg. 2020; 2020: 9251042.
[24]   | Kang SI, Gu MJ. Synchronous ileal inflammatory fibroid polyp and Meckel’s diverticulum found during laparoscopic surgery for adult intussusception. Yeungnam Univ J Med. 2019 Dec 18.
[25]   | Gupta R, Pokharia P, Kaur A. Adult Ileo-ileal Intussusception due to Inflammatory Fibroid Polyp. J Gastrointest Surg. 2019 Dec 2.
[26]   | Paramythiotis D, Goulas P, Moysidis M, Papavramidis T, Michalopoulos A. Bowel intussusception in adults: a report of three interesting cases and current trends for diagnosis nd surgical management. Hippokratia. 2019 Mar; 23(1): 37-41.
[27]   | Mader S, Ting J, Nabi H. Ileocolic intussusception from an inflammatory fibroid polyp: a rare cause of adult small bowel obstruction: Images for surgeons. ANZ Journal of Surgery. 2019 Mar; 89(3): E100-1.
[28]   | Jan ZU, Muslim M, Ullah K, Shoaib A, Ahmed N, Khan ZM, et al. Vanek’s tumor as an unusual cause of ileo-ileal intessuception - A unique case report. Ann Med Surg (Lond). 2018 Aug; 32: 14-7.
[29]   | Al Taei TH, Al Mail SA. Small bowel intussusception due to inflammatory fibroid polyp: A case report. Radiol Case Rep. 2018 Aug; 13(4): 801-4.
[30]   | Tajima S, Koda K. Locally infiltrative inflammatory fibroid polyp of the ileum: report of a case showing transmural proliferation. Gastroenterol Rep (Oxf). 2018; 6(2): 144-8.
[31]   | Carvalho A, Leitão P, Pinheiro J, Sá Fernandes M, Rodrigues M, Preto AS, et al. Small bowel intussusception in 2 adults caused by inflammatory polyps. Radiol Case Rep. 2017 Dec; 12(4): 710-4.
[32]   | Mochizuki T, Hirata Y, Kitamura S, Nishida T, Sakimoto H. Laparoscopic operation after pre-operative reduction of an intussusception-induced inflammatory fibroid polyp. J Surg Case Rep. 2017 Feb; 2017(2): rjx026.
[33]   | Grover AS, Kumar M, Yadav R, Sharma A, Chowdhary K, Zaman M, et al. Intussusception of Small Intestine as a Result of Inflammatory Fibroid Polyp Causing Small Bowel Obstruction in an Adult Patient. Kathmandu Univ Med J (KUMJ). 2017 Dec; 15(60): 352-4.
[34]   | Adams HS, Bergstrom B, Haines B, Roberts N. Inflammatory Fibroid Polyp: An Unusual Cause of Ileoileal Intussusception. Case Reports in Surgery. 2017; 2017: 1-4.
[35]   | Rais M, Chahdi H, Elfahssi M, Albouzidi A, Oukabli M. An Unusual Cause of Intestinal Obstruction in a Young Adult Patient: Inflammatory Fibroid Polyp. Case Rep Surg. 2017; 2017: 3675848.
[36]   | Basara I, Canda AE, Sagol O, Obuz F, Secil M. Intussusception and perforation due to an inflammatory fibroid polyp located in the ileum. Wien Klin Wochenschr. 2016 Oct; 128(19-20): 731-4.
[37]   | Hiremath S, Nanjappa N, Kamath S. Inflammatory fibroid polyp (IFP) of the terminal ileum presenting as acute intestinal obstruction without intussusception. BMJ Case Rep. 2015 Sep 7; 2015.
[38]   | Sakran N, Farkash I, Hershko D. Inflammatory fibroid polyp (Vanek’s tumour) causing a rare form of double invagination intussusception of the small bowel. ANZ J Surg. 2018 Jan; 88(1-2): E85-6.
[39]   | Kimura N, Hight M, Liang J, Willy R, Liang K, Camp J. Adult Intussusception Secondary to Inflammatory Fibroid Polyp. West J Emerg Med. 2015 Jul; 16(4): 581-2.
[40]   | Bae JS, Song JS, Hong S-M, Moon WS. An unusual presentation of an inflammatory fibroid polyp of the ileum: A case report. Oncol Lett. 2015 Jan; 9(1): 327-9.
[41]   | Joyce KM, Waters PS, Waldron RM, Khan I, Orosz ZS, Németh T, et al. Recurrent adult jejuno-jejunal intussusception due to inflammatory fibroid polyp - Vanek’s tumour: a case report. Diagn Pathol. 2014 Jun 27; 9: 127.
[42]   | Sulu B, Gunerhan Y, Kosemehmetoglu K. A rare ileal tumor causing anemia and intussusception: Inflammatory fibroid polyp. Turk J Gastroenterol. 2014 May 21; 25(1): 116-7.
[43]   | Teli B, Cp M, S S, Mv S. Ileo-ileal Intussusception in an Adult Caused by Vanek’s Tumour: A Rare Case Report. J Clin Diagn Res. 2013 Dec; 7(12): 2994-5.
[44]   | Neishaboori H, Maleki I, Emadian O. Jejunal intussusception caused by a huge Vanek’s tumor: a case report. Gastroenterol Hepatol Bed Bench. 2013; 6(4): 210-3.
[45]   | Jacobs TM, Lambrianides AL. Inflammatory fibroid polyp presenting as intussusception. Journal of Surgical Case Reports. 2013 Feb 22; 2013(2): rjt005-rjt005.
[46]   | Lasithiotakis K, Grisbolaki E, Filis D, Athanasakis I, Zoras O, Chalkiadakis G. Ileocolic Intussusception Precipitated by Diagnostic Colonoscopy: A Case Report. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2012 Jun; 22(3): e161-3.
[47]   | Rabbani K, Narjis Y, Jgounni R, Semlani Z, Difaa A, Benelkhaiat R, et al. Adult Intussusception Caused by an Inflammatory Fibroid Ileal Polyp. Acta Chirurgica Belgica. 2012 Jan; 112(2): 157-9.
[48]   | Morales-Fuentes GA, de Ariño-Suárez M, Zárate-Osorno A, Rodríguez-Jerkov J, Terrazas-Espitia F, Pérez-Manauta J. Vanek’s polyp or inflammatory fibroid polyp. Case report and review of the literature. Cir Cir. 2011 Jun; 79(3): 242-5, 263-7.
[49]   | Toydemir T. Inflammatory fibroid polyp of the ileum presenting with small bowel obstruction in an adult patient: a case report. J Med Case Rep. 2010 Aug 30; 4: 291.
[50]   | Gara N, Falzarano JS, Limm WM, Namiki TS, Tom LK. Ileal inflammatory fibroid polyp causing chronic ileocolic intussusception and mimicking cecal carcinoma. World J Gastrointest Oncol. 2009 Oct 15; 1(1): 89-92.
[51]   | Ruffolo C, Scarpa M, Bassi D, Angriman I. Inflammatory fibroid polyp causing intestinal obstruction following restorative proctocolectomy for ulcerative colitis. Dig Surg. 2009; 26(4): 285-6.
[52]   | Mohamud SO, Motorwala SA, Daniel AR, Tworek JA, Shehab TM. Giant ileal inflammatory fibroid polyp causing small bowel obstruction: a case report and review of the literature. Cases Journal. 2008; 1(1): 341.
[53]   | O’Kane AM, O’Donnell ME, McCavert M, Taylor K, Lee J, Wilkinson AJ. Inflammatory fibroid polyp of the ileum causing recurrent intussusception and chronic ischaemia: a case report. Cases J. 2008 Oct 16; 1(1): 244.
[54]   | Deschamps L, Bretagnol F, Couvelard A, Corcos O, Bedossa P, Panis Y. Inflammatory fibroid polyp in Crohn’s disease revealed by ileoileal intussusception: case report and review of the literature. Inflamm Bowel Dis. 2008 Sep; 14(9): 1317-20.
[55]   | Coulier B, Maldague P, Broze B, Gielen I. Ileal inflammatory fibroid polyp causing ileocolic intussusception. JBR-BTR. 2008 Aug; 91(4): 149-52.
[56]   | Costamagna D, Erra S, Zullo A, Servente G, Durando R. Small bowel intussusception secondary to inflammatory fibroid polyp of the ileum: report of a case. Chir Ital. 2008 Apr; 60(2): 323-7.
[57]   | El Hajj II, Sharara AI. Jejunojejunal intussusception caused by an inflammatory fibroid polyp. Case report and review of the literature. J Med Liban. 2007 Jun; 55(2): 108-11.
[58]   | Karamercan A, Kurukahvecioglu O, Yilmaz TU, Aygencel G, Aytaç B, Sare M. Adult ileal intussusception: An unusual emergency condition. Adv Therapy. 2006 Jan; 23(1): 163-8.
[59]   | Parasi A, Triantafillidis JK, Barbatzas C, Karakosta A, Condilis N, Sotiriou H. Coexistence of Crohn’s disease and inflammatory fibroid polyp of the small bowel. Report of a case and review of the literature. Ann Ital Chir. 2005 Aug; 76(4): 395-9.
[60]   | Jabar MF, Prasannan S, Gul YA. Adult intussusception secondary to inflammatory polyps. Asian J Surg. 2005 Jan; 28(1): 58-61.
[61]   | Bays D, Anagnostopoulos GK, Katsaounos E, Filis P, Missas S. Inflammatory fibroid polyp of the small intestine causing intussusception: a report of two cases. Dig Dis Sci. 2004 Oct; 49(10): 1677-80.
[62]   | Vijayaraghavan R, Sujatha Y, Santosh KV, Belagavi CS. Inflammatory fibroid polyp of jejunum causing jejuno-jejunal intussusception. Indian J Gastroenterol. 2004 Oct; 23(5): 190-2.
[63]   | Miyata T, Yamamoto H, Kita H, Yano T, Sunada K, Sekine Y, et al. A case of inflammatory fibroid polyp causing small-bowel intussusception in which retrograde double-balloon enteroscopy was useful for the preoperative diagnosis. Endoscopy. 2004 Apr; 36(4): 344-7.
[64]   | Gönül II, Erdem O, Ataoğlu O. Inflammatory fibroid polyp of the ileum causing intussusception: a case report. Turk J Gastroenterol. 2004 Mar; 15(1): 59-62.
[65]   | Topaloglu S, Ozel H, Saygun O, Avsar FM, Ustun H. Jejunal intussusception caused by an inflammatory fibroid polyp. Hepatogastroenterology. 2003 Dec; 50 Suppl 2: ccliv-cclv.
[66]   | Savargaonkar P, Morgenstern N, Bhuiya T. Inflammatory fibroid polyp of the ileum causing intussusception: report of two cases with emphasis on cytologic diagnosis. Diagn Cytopathol. 2003 Apr; 28(4): 217-21.
[67]   | Sah SP, Agrawal CS, Rani S. Inflammatory fibroid polyp of the jejunum presenting as intussusception. Indian J Pathol Microbiol. 2002 Jan; 45(1): 119-21.
[68]   | Balci NC, Radjazi S, Polat H. Adult intussusception secondary to inflammatory fibroid polyp: demonstration by MRI. European Radiology. 2000 Oct 20; 10(11): 1708-10.
[69]   | Eisen LK, Cunningham JD, Jr AHA. Intussusception in Adults: Institutional Review. J Am Coll Surg. 1999; 188(4): 6.
[70]   | Zubaidi A, Al-Saif F, Silverman R. Adult Intussusception: A Retrospective Review: Diseases of the Colon & Rectum. 2006 Oct; 49(10): 1546-51.
[71]   | Wiot JF, Spitz HB. Small Bowel Intussusception Demonstrated by Oral Barium. Radiology. 1970 Nov; 97(2): 361-6.
[72]   | Wiersma F, Allema JH, Holscher HC. Ileoileal intussusception in children: ultrasonographic differentiation from ileocolic intussusception. Pediatr Radiol. 2006 Oct 11; 36(11): 1177-81.
[73]   | del-Pozo G, Albillos JC, Tejedor D, Calero R, Rasero M, de-la-Calle U, et al. Intussusception in Children: Current Concepts in Diagnosis and Enema Reduction. Radio Graphics. 1999 Mar; 19(2): 299-319.
[74]   | Marsicovetere P, Ivatury S, White B, Holubar S. Intestinal Intussusception: Etiology, Diagnosis, and Treatment. Clinics in Colon and Rectal Surgery. 2016 Dec 22; 30(01): 030-9.
[75]   | Kim YH, Blake MA, Harisinghani MG, Archer-Arroyo K, Hahn PF, Pitman MB, et al. Adult Intestinal Intussusception: CT Appearances and Identification of a Causative Lead Point. RadioGraphics. 2006 May; 26(3): 733-44.
[76]   | Inayat F, Khan MA, Zafar F, Munir A. Inflammatory fibroid polyp of the duodenum: is endoscopic resection a feasible therapeutic choice? BMJ Case Reports. 2018 Nov; 11(1): e226972.
[77]   | Wang L-T, Wu C-C, Yu J-C, Hsiao C-W, Hsu C-C, Jao S-W. Clinical Entity and Treatment Strategies for Adult Intussusceptions: 20 Years Experience: Diseases of the Colon & Rectum. 2007 Nov; 50(11): 1941-9.