General Surgery Department, University General Hospital J. M. Morales Meseguer, Murcia, Spain.
Rev Esp Enferm Dig. 2010 Jan;102(1):32-40. doi: 10.4321/s1130-01082010000100005.
To analyze diagnostic and therapeutic options depending on the clinical symptoms, location, and lesions associated with intussusception, together with their follow-up and complications.
Patients admitted to the Morales Meseguer General University Hospital (Murcia) between January 1995 and January 2009, and diagnosed with intestinal invagination. Data related to demographic and clinical features, complementary explorations, presumptive diagnosis, treatment, follow-up, and complications were collected.
There were 14 patients (7 males and 7 females; mean age: 41.9 years-range: 17-77) who presented with abdominal pain. The most reliable diagnostic technique was computed tomography (8 diagnoses from 10 CT scans). A preoperative diagnosis was established in 12 cases. Invaginations were ileocolic in 8 cases (the most common), enteric in 5, and colocolic in 2 (coexistence of 2 lesions in one patient). The etiology of these intussusceptions was idiopathic or secondary to a lesion acting as the lead point for invagination. Depending on the nature of this lead point, the cause of the enteric intussusceptions was benign in 3 cases and malignant in 2. Ileocolic invaginations were divided equally (4 benign and 4 malignant), and colocolic lesions were benign (2 cases). Conservative treatment was implemented for 4 patients and surgery for 10 (7 in emergency). Five right hemicolectomies, 3 small-bowel resections, 2 left hemicolectomies, and 1 ileocecal resection were performed. Surgical complications: 3 minor and 1 major (with malignant etiology and subsequent death). The lesion disappeared after 3 days to 6 weeks in patients with conservative management. Mean follow-up was 28.25 months (range: 5-72 months).
A suitable imaging technique, preferably CT, is important for the diagnosis of intussusception. Surgery is usually necessary but we favor conservative treatment in selected cases.
分析与肠套叠相关的临床表现、部位和病变的诊断和治疗选择，并对其随访和并发症进行总结。
收集 1995 年 1 月至 2009 年 1 月期间在莫拉莱斯梅塞格尔综合大学医院（穆尔西亚）住院并诊断为肠套叠的患者资料。记录患者的人口统计学和临床特征、辅助检查、疑似诊断、治疗、随访和并发症。
共有 14 例患者（男 7 例，女 7 例；平均年龄 41.9 岁，范围 17-77 岁）表现为腹痛。最可靠的诊断技术是计算机断层扫描（10 次 CT 扫描中有 8 次诊断）。术前诊断为 12 例。套叠部位为回结型 8 例（最常见）、肠型 5 例、结肠型 2 例（1 例患者存在 2 处病变）。这些肠套叠的病因是特发性的或继发于作为套叠起点的病变。根据套叠起点的性质，3 例肠型肠套叠为良性，2 例为恶性。回结型肠套叠分为良性 4 例和恶性 4 例，结肠型病变均为良性（2 例）。4 例患者接受了保守治疗，10 例患者（7 例为紧急情况）接受了手术治疗。共实施了 5 例右半结肠切除术、3 例小肠切除术、2 例左半结肠切除术和 1 例回盲部切除术。手术并发症：3 例轻微，1 例严重（恶性病因，随后死亡）。接受保守治疗的患者病变在 3 天至 6 周后消失。平均随访时间为 28.25 个月（范围：5-72 个月）。
合适的影像学技术，最好是 CT，对肠套叠的诊断很重要。手术通常是必要的，但我们在选择病例时更倾向于保守治疗。
