Zielke A, Förster R, Klotter H J, Nies C, Rothmund M
Klinik für Allgemeinchirurgie, Universität Marburg.
Dtsch Med Wochenschr. 1991 Sep 20;116(38):1424-7. doi: 10.1055/s-2008-1063767.
An 86-year-old man was admitted to hospital because of transitory cramp-like abdominal pain of 6 days' duration. Immediately preceding admission he had suffered a short episode of vomiting and diarrhoea. There was no history of previous abdominal operation. On examination there were signs of incomplete mechanical ileus. Ultrasonography revealed an abnormal cockade with triple ring phenomenon at the ileocaecal junction and the "duck-beak phenomenon" as signs of enterocolic intussusception. Immediate laparotomy demonstrated a submucous lipoma of the terminal ileus as its cause.--If there is clinical suspicion of intussusception, even in the presence of atypical abdominal symptoms, ultrasonography is the procedure of choice to provide rapid diagnosis. In adults treatment is always surgical.
一名86岁男性因持续6天的短暂性绞痛样腹痛入院。入院前他曾有过短暂的呕吐和腹泻发作。既往无腹部手术史。检查发现有不完全性机械性肠梗阻的体征。超声检查显示在回盲部有异常的“三叶草”样伴三环现象以及“鸭嘴现象”,提示小肠结肠套叠。立即剖腹探查发现病因是末端回肠的黏膜下脂肪瘤。——如果临床上怀疑有肠套叠,即使存在非典型的腹部症状,超声检查也是快速诊断的首选方法。成人的治疗总是需要手术。