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| IMAGES IN ACADEMIC MEDICINE: REPUBLICATION |
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| Year : 2017 | Volume
: 3
| Issue : 3 | Page : 196-197 |
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A fortuitous fall
Justin B Hurie1, Mark J Seamon2
1 Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA
2 Department of Surgery, Division of Trauma and Surgical Critical Care, Temple University School of Medicine; OPUS 12 Foundation, Philadelphia, PA, USA
| Date of Web Publication | 21-Apr-2017 |
Correspondence Address:
Mark J Seamon
Department of Surgery, Division of Trauma and Surgical Critical Care, Temple University Hospital, 4th Floor Parkinson Pavilion, Philadelphia, PA
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/IJAM.IJAM_92_16
A case of traumatic fall associated with an incidental finding of a large right colonic mass is described. Computed tomography and intraoperative images are presented.
The following core competencies are addressed in this article: Medical knowledge, Patient care.
Republished with permission from: Hurie JB, Seamon MJ. A fortuitous fall. OPUS 12 Scientist 2008;2(5):4.
Keywords: Colonic adenocarcinoma, fall from standing, intussusception
How to cite this article:
Hurie JB, Seamon MJ. A fortuitous fall. Int J Acad Med 2017;3, Suppl S1:196-7 |
A 71-year-old intoxicated man was brought to the Emergency Department as a trauma activation after falling from a standing height. He was amnestic to the event and had ecchymotic and swollen left periorbital soft tissues. Additional findings on complete primary and secondary trauma survey included mild right lower quadrant abdominal tenderness. Portable chest radiograph focused assessment by sonography in trauma examination, and laboratory values were all unremarkable. Computed tomography evaluation revealed no traumatic injuries but was notable for an incidental finding of ileocecal intussusception [Figure 1]. Further questioning exposed a 3-week history of crampy abdominal pain and frequent loose stools. Colonoscopy was performed revealing a near-obstructing mass adjacent to the ileocecal valve without any synchronous lesion. He was brought to the operating suite during the same hospitalization where a right hemicolectomy was performed [Figure 2]. Surgical pathology revealed a 9-centimeter, moderately differentiated cecal adenocarcinoma invading through the muscularis propria into the subserosa but no serosal involvement. All 22 lymph nodes in the surgical specimen were negative for metastatic carcinoma. The patient recovered uneventfully from his operation. His planned outpatient surveillance includes serial stool guaiac, carcinoembryonic antigen, and hepatic function tests, along with serial chest radiographs and colonoscopic evaluations. The reader is referred to external sources for further information on this topic.[1],[2],[3] | Figure 1: Computed tomography obtained during routine trauma evaluation. An intussusception is seen in the right lower quadrant
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 | Figure 2: Surgical specimen containing the right lower quadrant mass previously seen on computed tomography
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Acknowledgement
Justifications for re-publishing this scholarly content include: (a) The phasing out of the original publication after a formal merger of OPUS 12 Scientist with the International Journal of Academic Medicine and (b) Wider dissemination of the research outcome(s) and the associated scientific knowledge.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Weilbaecher D, Bolin JA, Hearn D, Ogden W 2 nd. Intussusception in adults. Review of 160 cases. Am J Surg 1971;121:531-5.  |
| 2. | Huang BY, Warshauer DM. Adult intussusception: Diagnosis and clinical relevance. Radiol Clin North Am 2003;41:1137-51. |
| 3. | Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR. Meckel diverticulum: The Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg 2005;241:529-33. |
[Figure 1], [Figure 2]
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