Gesslein M, Koscheck T, Kusch B
Chirurgische Klinik Waldkrankenhaus St. Marien, Erlangen.
Dtsch Med Wochenschr. 2004 Sep 17;129(38):1970-2. doi: 10.1055/s-2004-831834.
A 39-year-old patient presented with a history of constipation, abdominal pain and nausea. Magnetic resonance imaging showed a colonic tumour. Biopsy of the tumour did not reveal the diagnosis.
The abdomen was tense on palpation and inflammation parameters were elevated. On abdominal x-ray signs of obstructive colonic ileus could be seen. Endoscopic investigation revealed a tumorous stricture of the transverse colon presenting as intussusception with cockade phenomenon during sonography.
Because of obstructive ileus laparotomy was performed with extended right hemicolectomy and end-to-end ileotransversostomy. Histology showed the rare finding of colonic intussusception due to a capillary hemangioma. Post-operative clinical course was normal without any further signs or symptoms of systemic disease.
Intussusception in adult patients can be a rare complication due to gastrointestinal hemangioma. Endoscopy and radiologic imaging may help to establish diagnosis. Surgical resection of the involved bowel segment seems to be a safe and effective treatment. Nevertheless congenital disease must be excluded to prevent further complications.
一名39岁患者有便秘、腹痛和恶心病史。磁共振成像显示结肠肿瘤。肿瘤活检未明确诊断。
触诊时腹部紧张，炎症指标升高。腹部X线显示结肠梗阻性肠梗阻征象。内镜检查发现横结肠肿瘤性狭窄，超声检查时呈套叠伴三色征。
因梗阻性肠梗阻行剖腹手术，扩大右半结肠切除术及端端回肠横结肠吻合术。组织学检查显示罕见的因毛细血管瘤导致的结肠套叠。术后临床过程正常，无任何全身性疾病的进一步体征或症状。
成人患者的套叠可能是胃肠道血管瘤引起的罕见并发症。内镜检查和放射影像学检查有助于确诊。手术切除受累肠段似乎是一种安全有效的治疗方法。然而，必须排除先天性疾病以预防进一步并发症。
