Lin Mong-Wei, Chen Kuo-Hsin, Lin Heng-Fu, Chen Hsin-An, Wu Jiann-Ming, Huang Shih-Horng
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
J Laparoendosc Adv Surg Tech A. 2007 Dec;17(6):789-92. doi: 10.1089/lap.2007.0035.
Intussusception is the second most common abdominal emergency in children. In contrast, it is rare in adults. Adult intussusception represents only 1%-3% of patients with bowel obstruction. Although 95% of intussusception in children is idiopathic, merely 7% of adult intussusception is considered idiopathic. Owing to vague symptoms and signs, the preoperative diagnosis of adult intussusception is difficult. Once adult intussusception is diagnosed, surgical intervention is indicated because about half of both colonic and small intestinal intussusceptions are caused by malignant lesions. In this paper, we describe a case of ileoileal intussusception caused by an intestinal lipoma that was diagnosed preoperatively by computed tomography scans and was treated successfully by laparoscopy-assisted surgery. The patient was discharged uneventfully 4 days after the operation. We recommend laparoscopy-assisted surgery as a feasible therapeutic option for adult intussusception.
肠套叠是儿童第二常见的腹部急症。相比之下,在成人中则较为罕见。成人肠套叠仅占肠梗阻患者的1% - 3%。虽然儿童肠套叠95%为特发性,但成人肠套叠仅有7%被认为是特发性的。由于症状和体征不明确,成人肠套叠的术前诊断较为困难。一旦诊断为成人肠套叠,就需要进行手术干预,因为结肠和小肠肠套叠约一半是由恶性病变引起的。在本文中,我们描述了一例由肠道脂肪瘤引起的回肠 - 回肠套叠病例,该病例通过计算机断层扫描术前确诊,并通过腹腔镜辅助手术成功治疗。患者术后4天顺利出院。我们推荐腹腔镜辅助手术作为成人肠套叠可行的治疗选择。