Utility of 3D Visualization in Surgical Planning

Utility of 3D Visualization in Surgical Planning Khan M. Siddiqui, MD Case 1: Adult Intussusception Introduction: Intussusception is the invagination of one bowel segment (intussusceptum) into an immediately distal bowel segment (intussuscipiens). It can be classified according to the site of invagination as enteroenteric, colocolic, and enterocolic. By far, the majority of intussusceptions are seen in children under the age of 3 years, in whom it is the second most common abdominal emergency. Intussusception in adults is comparatively rare but often points to significant underlying pathology. An estimated two-thirds of pathologies detected as causes of adult intussusception are benign or malignant neoplasms, and more than half of these neoplasms are malignant . As many as 80% of adult patients with intussusceptions are found to have specific causes (lead points), including but not limited to: benign or malignant tumor, lipoma, Meckel’s diverticulum, prolapsed gastric mucosa, aberrant pancreas, adhesions, foreign body, feeding tube, chronic ulcer, gastroenterostomy, and trauma. Other causes that may not have an anatomic lead point are celiac disease, scleroderma, Whipple’s disease, and anxiety. Untreated intussusception usually progresses to intestinal obstruction, with patients presenting with acute abdominal pain. In rare cases, the intussusceptum becomes strangulated, necrotic, and gangrenous, leading to peritonitis, sepsis, and death.