PDF(Pubmed)
Abstract：
A jejunal intussusception as a presentation of retroperitoneal liposarcoma (RLPS) is a rare occurrence. The majority of RLPS are presented as an abdominal mass, however, having a jejunal obstruction is an interesting case. The aim is to describe the management of jejunal intussusception secondary to atypical lipomatous tumours with concurrent RLPS. A 61-year-old lady presented with a sudden onset of intestinal obstruction with 1 month of constitutional symptoms and an enlarging right lumbar mass. Computed tomography showed a small bowel intussusception with diffuse peritoneal and retroperitoneal lipomatosis. Emergency exploratory laparotomy, segmental bowel resection, and partial excision of intraperitoneal mesenteric lipoma were performed. A stage En-bloc resection of the RLPS and right nephrectomy was done later. However, she refused for subsequent surgery. A complete resection is the gold standard in managing RLPS. In this report, the management is rendered not to the standard as the patient first presented with intestinal obstruction requiring emergency reduction with a piecemeal resection. A stage surgery was required to determine a promising prognosis, but the patient refused such surgery. A small bowel intussusception in adults is rare but is mostly caused by a tumor or neoplasm. Early recognition of the complexity of the case should be preempted and referred to the tertiary team for further definitive surgery. Patient exhaustion from the subsequent surgery might hamper the only management available for the case.
摘要：
空肠肠套叠作为腹膜后脂肪肉瘤（RLPS）的表现很少发生。大部分RLPS表现为腹部肿块，然而,有空肠阻塞是一个有趣的案例。目的是描述并发RLPS的非典型脂肪瘤性肿瘤继发的空肠肠套叠的处理。一名61岁的女士突然出现肠梗阻，伴有1个月的宪法症状和右腰椎肿块扩大。计算机断层扫描显示小肠肠套叠伴弥漫性腹膜和腹膜后脂肪瘤病。急诊剖腹探查术,节段性肠切除术,行腹膜内肠系膜脂肪瘤部分切除术。随后进行了RLPS的整块切除术和右肾切除术。然而,她拒绝了随后的手术。完全切除是管理RLPS的金标准。在这份报告中,由于患者首先出现肠梗阻，需要通过零碎切除术进行紧急复位，因此治疗不符合标准。需要分期手术来确定有希望的预后，但是病人拒绝了这种手术。成人小肠套叠很少见，但主要由肿瘤或肿瘤引起。应尽早认识到病例的复杂性，并将其转介给三级团队进行进一步的明确手术。随后手术的患者精疲力竭可能会妨碍该病例的唯一可用管理。
