Shiba Hiroaki, Mitsuyama Yoshinobu, Hanyu Ken, Ikeuchi Kenji, Hayashi Hirotaka, Yanaga Katsuhiko
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Case Rep Gastroenterol. 2009 Nov 21;3(3):377-381. doi: 10.1159/000254859.
Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.
成人肠套叠较为罕见,仅占所有肠套叠病例的5%,术前诊断困难。我们在此报告一例术前诊断为小肠脂肪瘤所致的成人肠套叠病例。一名33岁男性因上腹部绞痛3周病史入院。计算机断层扫描显示回肠壁增厚,提示肠套叠。结肠镜检查发现回结肠套叠。用于复位回结肠套叠的钡灌肠显示在回盲瓣近端15厘米处的回肠有一个小肠肿瘤。肠套叠得以复位,患者接受了包括小肠肿瘤在内的部分回肠切除术。组织学检查结果证实为小肠脂肪瘤。患者恢复良好,至今状况良好。