PDF(Pubmed)
Abstract：
Intussusception in adults is a rare surgical emergency. Unlike in children, most adult intussusceptions arise from a pathological lead point. Ileal intussusception caused by a submucosal liposarcoma is a particularly rare phenomenon. This report describes the diagnosis and management of adult ileal intussusception secondary to submucosal liposarcoma in adult to provide a reference for future clinical work. A 64-year-old female presented to the emergency department with worsening abdominal pain associated with an 8 h history of intermittent vomiting. Based on physical examination, laboratory investigations, and computed tomography, the most likely diagnosis was ileal intussusception secondary to liposarcoma. Thus, emergency laparotomy was performed. During exploration, an ileal invagination was visualised approximately 30 cm from the ileocecal valve, and a flexible polypoid mass was palpable at the lead point of the intussusception. Subsequently, the patient underwent radical resection of pathological tissues with a primary end-to-end ileal anastomosis. Histopathological examination revealed a well-differentiated submucosal liposarcoma. Postoperatively, the patient recovered uneventfully and was doing well at the 6-month follow-up in the outpatient clinic. Thus, clinicians should consider the origin of submucosal liposarcomas in adult with intussusception. Once ileal intussusception secondary to submucosal liposarcoma is diagnosed, timely radical resection is recommended.
摘要：
成人肠套叠是一种罕见的外科急症。与儿童不同，大多数成人肠套叠是由病理导点引起的。由粘膜下脂肪肉瘤引起的回肠肠套叠是一种特别罕见的现象。本报告介绍成人黏膜下脂肪肉瘤继发回肠肠套叠的诊断和治疗，为今后的临床工作提供参考。一名64岁的女性出现在急诊科，腹痛恶化，并伴有8小时的间歇性呕吐史。根据体检,实验室调查,和计算机断层扫描，最有可能的诊断是继发于脂肪肉瘤的回肠肠套叠.因此，进行了紧急剖腹手术。在探索过程中,回肠瓣约30厘米处可见回肠内陷，在肠套叠的导联点可触及到柔性息肉样肿块。随后，患者接受了病理组织的根治性切除术，并进行了一次端端回肠吻合术。组织病理学检查显示分化良好的粘膜下脂肪肉瘤。术后,患者恢复顺利,在门诊6个月随访时表现良好.因此，临床医生应考虑成人肠套叠粘膜下脂肪肉瘤的起源。一旦诊断为继发于粘膜下脂肪肉瘤的回肠肠套叠，建议及时根治性切除。
