Andrei S, Andrei A, Tonea A, Andronesi D, Preda C, Herlea V, Popescu I
Centrul de Chirurgie Generală şi Transplant Hepatic, Institutul Clinic de Boli Digestive şi Transplant Hepatic Fundeni, Bucureşti.
Chirurgia (Bucur). 2011 Jan-Feb;106(1):131-6.
Intestinal occlusion due to intussusception produced by intestinal tumors is a very rare condition. Gastrointestinal stromal tumors are also rare digestive neopasias, with an impredictable malignant behavior, which are usually growing outside the intestinal wall, being rarely the initiators of an intestinal intussusception. We present the case of a 59 years old female, admitted in our hospital to elucidate the etiology of her iron deficient anaemia, which developed an intestinal occlusion at the intestinal preparation for colonoscopy. The abdominal CT scan performed in emergency conditions highlighted occlusive intestinal tumor complicated with intestinal intussusception. We performed an emergency laparotomy that revealed intestinal occlusion due to ileo-ileal intussusception produced by an ileal tumor. The surgical intervention consisted in segmental ileal enterectomy including the tumor with latero-lateral entero-enteral anastomosis. The patient recovered without complications. The histopathological and immunohisto-chemical examinations established the diagnose of gastro-intestinal stromal tumor with high risk malignant behavior, therefore the patient was guided in the oncological department for specific treatment and oncological surveillance.
肠道肿瘤引起的肠套叠导致的肠梗阻是一种非常罕见的情况。胃肠道间质瘤也是罕见的消化系统肿瘤，其恶性行为不可预测，通常生长在肠壁外，很少引发肠套叠。我们报告一例59岁女性病例，因缺铁性贫血入住我院以明确病因，在结肠镜肠道准备时发生了肠梗阻。急诊行腹部CT扫描显示为闭塞性肠道肿瘤并伴有肠套叠。我们进行了急诊剖腹手术，发现是回肠肿瘤导致回肠-回肠套叠引起的肠梗阻。手术干预包括切除包括肿瘤在内的部分回肠，并进行侧侧肠-肠吻合术。患者术后恢复顺利，无并发症。组织病理学和免疫组织化学检查确诊为具有高风险恶性行为的胃肠道间质瘤，因此患者被转至肿瘤科进行特异性治疗和肿瘤监测。
