未经证实:健康成人肠套叠是罕见的,通常与肿瘤疾病相关。此病例报告介绍了一个需要回肠结肠切除术的健康成年人的回肠结肠肠套叠到达降结肠的病例。
方法:我们介绍一例78岁男性急性非特异性腹痛患者。病史并不明显。术前放射学评估显示小肠内陷到结肠中,没有任何息肉或肿瘤的迹象。进行了紧急剖腹手术,切除了受影响的肠。病理学家描述了49厘米长的肠套叠结肠和另一个7厘米的末端回肠肠套叠。可以识别出在结肠中具有延伸超过8cm的多个息肉的圆形区域。微观发现显示该区域内有低度发育不良。手术后,患者在住院10天后康复出院。
未经证实:成人肠套叠很少见,临床表现包括非特异性症状,这使得诊断具有挑战性。在90%的案例中,发现病理性病变(三分之二是肿瘤)。由于肿瘤的高发生率以及穿孔和肿瘤扩散的风险,应手术治疗涉及结肠的肠套叠,而无需事先减少。
结论:在文献中,肿瘤性疾病是成人肠套叠的主要原因。本报告介绍了一种罕见的回肠肠套叠病例,该病例通过结肠次全切除术成功治疗了降结肠。
UNASSIGNED: Intussusception in healthy adults is rare and often associated with oncologic diseases. This
case report presents a
case of an ileo-colic intussusception reaching down to the descending colon in a healthy adult that required ileo-colic resection.
METHODS: We present a
case of a 78-year-old male patient with acute onset unspecific abdominal pain. The medical history was unremarkable. Preoperative radiologic assessments showed an invagination of the small intestine into the colon without any signs of polyps or tumours. An emergency laparotomy with resection of the affected intestine was performed. The pathologist described a 49 cm length of intussuscepted colon and an additional 7 cm intussusception of the terminal ileum. A circular area with multiple polyps extending over 8 cm in the colon could be identified. The microscopic findings showed a low-grade dysplasia within this area. Following surgery, the patient was discharged to rehabilitation after a ten-day hospitalization.
UNASSIGNED: Intussusception in adults is rare and the clinical presentation includes unspecific symptoms making the diagnosis challenging. In 90% of the cases, a pathologic lesion is found (two-thirds are neoplasms). An intussusception involving the colon should be treated surgically without prior reduction due to the high incidence of a neoplasm and the risk for perforation and tumour dissemination.
CONCLUSIONS: In the literature, neoplastic disease represents the major cause for intussusception in adults. This report presents a rare
case of an ileo-colic intussusception reaching down to the descending colon treated successfully with a subtotal colectomy.