Segovia-Lohse Helmut Alfredo
II Cátedra de Clínica Quirúrgica, Universidad Nacional de Asunción, Asunción, Paraguay.
Cir Cir. 2011 May-Jun;79(3):252-55, 274-7.
Intussuception is an uncommon condition in adults. It is usually secondary to an organic lesion that may be malignant. The most common clinical presentation is as a partial bowel obstruction that requires surgical management. Preoperative diagnosis remains difficult; therefore, this paper presents a case report and a brief review of adult intussusception.
We present the case of a 24-year-old female with a 36-h evolution of lower abdominal pain with nausea, vomiting and diarrhea and a previous episode 8 days earlier. Pneumoperitoneum was observed on chest x-ray and surgery was decided upon. Peritonitis due to ileoileal intussusception was found, caused by an inflammatory fibroid polyp with microperforations. Small bowel resection with end-to-end anastomosis was performed and the patient had an uneventful recovery.
Adult intussusception is an infrequent condition with nonspecific symptoms such as pain, nausea and vomiting. With more frequent use of tomography in patients with abdominal pain, correct diagnosis can be achieved. Treatment requires resection of the involved bowel without attempted reduction.
肠套叠在成人中并不常见。它通常继发于可能为恶性的器质性病变。最常见的临床表现为部分性肠梗阻，需要手术治疗。术前诊断仍然困难；因此，本文报告一例病例并对成人肠套叠进行简要综述。
我们报告一例24岁女性，下腹部疼痛伴恶心、呕吐和腹泻36小时，8天前曾有过类似发作。胸部X线检查发现气腹，遂决定进行手术。术中发现回肠套叠导致的腹膜炎，病因是炎性纤维瘤息肉伴微小穿孔。行小肠切除端端吻合术，患者恢复顺利。
成人肠套叠罕见，有疼痛、恶心和呕吐等非特异性症状。随着腹痛患者越来越频繁地使用断层扫描，可实现正确诊断。治疗需要切除受累肠段，不尝试复位。
