Department of General Surgery, Imam Khomeini Hospital Complex, End of Keshavarz Boulevard, Tehran University of Medical Sciences, Tehran 1419733141, Iran.
Int J Surg. 2010;8(4):318-20. doi: 10.1016/j.ijsu.2010.02.013. Epub 2010 Mar 30.
Intussusception is a rare cause of intestinal obstruction in adult patients. The etiology of malignant nature has been reported to be more frequent in this group and the diagnosis is usually made at operation. Few reports are published for this clinical entity from Middle East.
The medical records of all adult patients admitted with the diagnosis of intussusception in a tertiary care center between 1989 and 2009 were reviewed.
There were 15 cases of intussusception in this 20 years period. The mean age of patients was 33.6 years, 8 females and 7 males. In 14 cases the leading point of intussusception was in small bowel. Resection and primary anastomosis was the selected procedure in 13 patients; one patient underwent colostomy and one reduction alone. Malignant cause was detected in only 2 cases. 7 Patients were operated on with diagnosis of intussusception according to imaging findings. The diagnosis was made at operation in the remaining 8 cases. Only one anastomotic leakage occurred in patient on systemic steroids.
The mean age of our patients is relatively low with more benign etiologies in small bowel. The CT scan may be the most helpful imaging modality in suspected cases but decision for operation in acute presentations should not be deferred for definite diagnosis. Resection of the involved bowel segment and primary anastomosis is associated with a good outcome.
肠套叠是成人肠梗阻的罕见原因。据报道，在这一人群中，恶性病因更为常见，且通常在手术时才做出诊断。来自中东的此类临床病例报道较少。
回顾了 1989 年至 2009 年期间在一家三级护理中心因肠套叠而入院的所有成年患者的病历。
在这 20 年期间，共有 15 例肠套叠患者。患者的平均年龄为 33.6 岁，女性 8 例，男性 7 例。在 14 例病例中，肠套叠的起点位于小肠。13 例患者选择了切除和一期吻合术；1 例患者行结肠造口术，1 例仅行复位术。仅在 2 例中发现恶性病因。7 例患者根据影像学表现行肠套叠手术。其余 8 例在手术中做出诊断。仅 1 例接受全身类固醇治疗的患者发生吻合口漏。
我们的患者平均年龄相对较低，且小肠的良性病因更多。CT 扫描可能是疑似病例最有帮助的影像学检查方法，但对于急性表现的患者，不应为明确诊断而延迟手术。切除受累肠段并进行一期吻合术与良好的结果相关。
