Uchino Motoi, Ikeuchi Hiroki, Matsuoka Hiroki, Tanaka Keita, Kuno Takashi, Ohshima Tsutomu, Tsukamoto Kiyoshi, Nakamura Mitsuhiro, Gega Makoto, Yagyu Toshihiko, Nakano Hiroki, Noda Masafumi, Tomita Naohiro
Second Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Surg Today. 2008;38(4):366-70. doi: 10.1007/s00595-007-3624-3. Epub 2008 Mar 27.
Postoperative enteroenteric intussusception is a rare complication in adult patients with Crohn's disease. We treated two patients with Crohn's disease accompanied by an ileal obstruction, each of whom underwent an elective resection. In both, the upper left quadrant of the abdoment became progressively distended following ileocecal resection and each required surgical treatment after diagnosis of postoperative enteroenteric intussusception by abdominal computed tomography scanning, as the intussusception could not be reduced by conservative treatment. There were no Crohn's lesions found in the intussuscepted specimens, and the condition was thought to have been caused by a segment of thickened and fibrotic intestine that had developed because of long-standing bowel dilatation from obstructive Crohn's lesions. In one of the patients, the intussusceptum was irreducibly incarcerated and required a resection, whereas it was able to be manually reduced in the other.
术后小肠肠套叠是成年克罗恩病患者中一种罕见的并发症。我们治疗了两名患有克罗恩病并伴有肠梗阻的患者，他们均接受了择期切除术。两名患者在回盲部切除术后左上腹均逐渐膨隆，经腹部计算机断层扫描诊断为术后小肠肠套叠后，由于保守治疗无法复位，均需手术治疗。套叠标本中未发现克罗恩病变，推测该情况是由一段因克罗恩病梗阻性病变长期肠扩张而增厚和纤维化的肠管所致。其中一名患者的套入部无法复位且嵌顿，需要进行切除，而另一名患者的套入部能够手动复位。
