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[结肠毛细血管瘤作为成人肠套叠的罕见病因]

[Capillary hemangioma of the colon as a rare cause of intussusception in adults].

作者信息

Gesslein M, Koscheck T, Kusch B

机构信息

Chirurgische Klinik Waldkrankenhaus St. Marien, Erlangen.

出版信息

Dtsch Med Wochenschr. 2004 Sep 17;129(38):1970-2. doi: 10.1055/s-2004-831834.

Abstract

HISTORY AND ADMISSION FINDINGS

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.

INVESTIGATION

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.

TREATMENT AND CLINICAL COURSE

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.

CONCLUSION

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.

摘要

病史及入院检查结果

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。

检查

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。

治疗及临床过程

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。

结论

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。

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