Bayle S, Rossi P, Bagneres D, Demoux A L, Ashero A, Dales J P, Vitton V, Frances Y, Granel B
Service de médecine interne, hôpital Nord, chemin des Bourrelly, 13326 Marseille cedex 20, France.
Rev Med Interne. 2005 Mar;26(3):233-7. doi: 10.1016/j.revmed.2004.10.030. Epub 2004 Dec 16.
Acute ileum intussusception is a frequent and mostly benign condition in childhood. Conversely, it is a rare condition during adulthood and generally associated with an underlying malignancy. We report a familial form of benign inflammatory fibroid polyps, revealed by an acute ileum intussusception.
A 41-year-old man, whose mother had undergone three surgical procedures for acute ileum intussusception associated with inflammatory fibroid polyp, was admitted for a abdominal pain that started three month ago. The patient displayed alteration of the intestinal transit, weight loss and sub-occlusive syndrome. Upper and lower endoscopies, performed before admission, were normal. In the emergency room, the abdominal computed tomography-scan revealed an acute intussusception of the last loop of the small intestine, probably caused by a tumor and leading to an occlusive syndrome. Surgical resection and histological analysis concluded to an inflammatory fibroid polyp. Clinical outcome was excellent.
Inflammatory fibroid polyp is always a benign tumor. It is usually isolated, expressing itself mainly in the form of an acute intussusception when located in the small bowel. The familial form presented here is exceptional and illustrates the possibility of an inherited transmission of this disease. However the pathogenesis of this type of polyp is still unclear.
急性回肠套叠在儿童期是一种常见且大多为良性的病症。相反,在成年期它是一种罕见病症,通常与潜在的恶性肿瘤相关。我们报告了一例由急性回肠套叠发现的家族性良性炎性纤维瘤性息肉。
一名41岁男性,其母亲曾因与炎性纤维瘤性息肉相关的急性回肠套叠接受过三次外科手术,因三个月前开始的腹痛入院。患者出现肠道转运改变、体重减轻和亚梗阻综合征。入院前进行的上下消化道内镜检查均正常。在急诊室,腹部计算机断层扫描显示小肠末段急性套叠,可能由肿瘤引起并导致梗阻综合征。手术切除及组织学分析诊断为炎性纤维瘤性息肉。临床结局良好。
炎性纤维瘤性息肉始终是一种良性肿瘤。它通常为单发,位于小肠时主要表现为急性套叠形式。此处呈现的家族性形式较为罕见,说明了这种疾病存在遗传传递的可能性。然而,这种类型息肉的发病机制仍不清楚。