Arthur A L, Garvey R, Vaness D G
Department of Pediatrics, Bridgeport Hospital.
Conn Med. 1990 Sep;54(9):492-4.
Colocolic intussusception is an uncommon cause of pediatric intestinal obstruction in North America; 95% of cases are ileocolic in location, with an equal percentage in which no pathologic lead point is evident on barium enema or laparotomy. In the last 20 years less than 3% of approximately 32,500 reported cases of intussusception originated in the colon. In a significant number of these cases juvenile polyps were identified as leading points. The majority of juvenile polyps occur in the rectosigmoid colon within the reach of a standard pediatric sigmoidoscope. These tumors most often cause painless hematochezia. Occasionally, juvenile polyps may grow large and serve as lead points for colocolic intussusception when located in the proximal colon. Pediatric patients presenting with documented colocolic intussusception should suggest the possibility of a colonic polyp or other mass lesion. Careful physical examination and barium studies should provide important diagnostic clues. Treatment is aimed at removing the lead point in patients presenting with intestinal obstruction. Colonoscopic polypectomy performed by an experienced endoscopist may serve as an alternative to surgical removal of the polyp. We report a case in a three-old-child of colocolic intussusception caused by a colonic polyp, and review some of the salient features of this clinical entity.
结肠结肠套叠在北美是小儿肠梗阻的罕见病因；95%的病例发生在回结肠部位，在钡剂灌肠或剖腹手术中无明显病理引导点的病例占相同比例。在过去20年中，在约32500例报告的肠套叠病例中，起源于结肠的不到3%。在这些病例中有相当一部分发现幼年息肉是引导点。大多数幼年息肉发生在标准小儿乙状结肠镜可及范围内的直肠乙状结肠。这些肿瘤最常引起无痛性便血。偶尔，幼年息肉可能长得很大，当位于近端结肠时可作为结肠结肠套叠的引导点。出现结肠结肠套叠记录的儿科患者应提示结肠息肉或其他肿块病变的可能性。仔细的体格检查和钡剂检查应提供重要的诊断线索。治疗旨在消除肠梗阻患者的引导点。由经验丰富的内镜医师进行的结肠镜息肉切除术可作为手术切除息肉的替代方法。我们报告一例3岁儿童因结肠息肉引起的结肠结肠套叠病例，并回顾该临床实体的一些显著特征。
