成人肠套叠很少发生,通常是由良性或恶性病因的可识别的导联引起的。这里,我们介绍了一名19岁的男性,他向急诊科就诊,抱怨腹痛,顽固性恶心,以及血性腹泻和便秘之间的波动。这些症状在两个月前就开始了,并且严重程度有所增加,导致明显的食欲变化。获得了腹部和盆腔计算机断层扫描,没有造影,其中显示了回盲肠肠套叠进入横结肠并导致小肠梗阻的证据。病人做了剖腹探查术,由于存在6.8厘米的盲肠肿块并可触及肠系膜淋巴结肿大,导致部分回肠结肠切除术。根据组织学组合,病理标本被鉴定为伯基特淋巴瘤,免疫组织化学,和荧光原位杂交结果。目前,病人正在接受三个周期的利妥昔单抗,环磷酰胺,长春新碱,阿霉素,大剂量甲氨蝶呤,异环磷酰胺,依托泊苷,和大剂量阿糖胞苷(R-CODOX-M/IVAC)按照Magrath方案治疗低危Burkitt淋巴瘤。
Adult intussusception is an infrequent occurrence typically resulting from an identifiable lead point of a benign or malignant etiology. Here, we present a case of a 19-year-old male who presented to the emergency department with complaints of abdominal pain, intractable nausea, and fluctuations between bloody diarrhea and constipation. These symptoms had begun two months prior and had increased in severity, resulting in significant appetite changes. An abdominal and pelvic computed tomography scan without contrast was obtained, which showed evidence of intussusception of the ileocecum into the transverse colon with resultant small bowel obstruction. The patient underwent an exploratory laparotomy, which resulted in a partial ileocolectomy due to the presence of a 6.8 cm cecal mass with palpable mesenteric lymphadenopathy. The pathologic specimen was identified as Burkitt lymphoma based on a combination of histologic, immunohistochemical, and fluorescence in situ hybridization findings. Currently, the patient is undergoing three cycles of rituximab, cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate, ifosfamide, etoposide, and high-dose cytarabine (R-CODOX-M/IVAC) per Magrath protocol for low-risk Burkitt lymphoma.