Teyha Penn S, Chandika Alphonce, Kotecha Vihar R
Department of Surgery, Weill Bugando University College of Health Sciences, P,O,Box 1464, Mwanza, Tanzania.
J Med Case Rep. 2011 Aug 17;5:389. doi: 10.1186/1752-1947-5-389.
Intussusception in pediatrics is widely documented and well described. On the basis of the literature, however, adult intussusception is a rare entity with a prevalence of from 1% to 5%. The majority of adult patients with intussusception have an underlying pathology that needs to be identified by performing a proper physical examination and a wide array of investigations.
We present a case of a 66-year-old African man who presented to our emergency department with a mass protruding per anus with obstipation. During laparotomy, we found that the sigmoid colon had intussuscepted into the rectum and out from the anus. Other abdominal viscera were normal and without any obvious mesenteric lymphadenopathy. Sigmoid colectomy and spectacle colostomy were performed. Grossly, the excised bowel looked normal, but the histologic results showed features of necrosis and chronic inflammation.
While 70% to 90% of cases of adult intussusception have an identifiable cause or lesion, most pediatric intussusceptions are idiopathic. The presentation in an adult described herein was of an uncommon idiopathic type with no identifiable cause found on the basis of the history, physical examination, or histological findings.
小儿肠套叠有广泛的文献记载且描述详尽。然而，根据文献，成人肠套叠是一种罕见疾病，患病率为1%至5%。大多数成人肠套叠患者有潜在病理状况，需要通过适当的体格检查和一系列检查来确定。
我们报告一例66岁非洲男性病例，该患者因肛门肿物突出伴便秘前来我院急诊科就诊。剖腹手术时，我们发现乙状结肠套入直肠并从肛门脱出。其他腹部脏器正常，无明显肠系膜淋巴结肿大。行乙状结肠切除术及双筒结肠造口术。大体上，切除的肠管外观正常，但组织学结果显示有坏死和慢性炎症特征。
虽然70%至90%的成人肠套叠病例有可识别的病因或病变，但大多数小儿肠套叠是特发性的。本文所述成人病例表现为罕见的特发性类型，根据病史、体格检查或组织学检查结果未发现可识别的病因。
