Saha N, Ferdous K N, Rahman M A, Islam M K
Department of Peadiatric Surgery, Mymensingh Medical College & Hospital, Mymensingh, Bangladesh.
Mymensingh Med J. 2012 Apr;21(2):333-6.
Intussusception secondary to Primary Non-Hodgkin lymphoma presenting colo-colic variety is a very rare clinical entity and sometimes causing diagnostic dilemma due to non-specific, varied & wide spectrum presentation. In this study, a 9 years female child presented with recurrent, intermittent, colicky abdominal pain with occasional bilious vomiting, along with a left illiac fossa swelling & occasional per rectal bleeding and constipation for 3 months was clinically diagnosed as a case of recurrent obstructing intussusception. At laparotomy, a colo-colic intussusception with prolapsed intussusception was marked & finally on histopathology, she was diagnosed as a case of colo-colic variety of intussusception due to primary Non-Hodgkin lymphoma- a pathological lead point in mid transverse colon. After uneventful recovery of post operative period she was treated with combination chemotherapy accordingly & follow up was given up to 5 years. She had been found alright without any recurrence or organ involvement. The study focused on the avoidance of unusual delay in diagnosis as well as in proper management of rare variants of intussusception.
原发性非霍奇金淋巴瘤继发的结肠-结肠型肠套叠是一种非常罕见的临床病症,有时因其非特异性、多样且广泛的表现而导致诊断困境。在本研究中,一名9岁女童出现反复、间歇性绞痛性腹痛,伴有偶尔的胆汁性呕吐,同时伴有左下腹肿胀、偶尔的直肠出血和便秘3个月,临床诊断为复发性梗阻性肠套叠。在剖腹手术中,标记了伴有套叠脱垂的结肠-结肠型肠套叠,最终经组织病理学检查,她被诊断为原发性非霍奇金淋巴瘤导致的结肠-结肠型肠套叠——横结肠中部的一个病理性套入点。术后恢复顺利后,她接受了相应的联合化疗,并进行了长达5年的随访。发现她情况良好,没有任何复发或器官受累。该研究重点在于避免诊断的异常延迟以及对罕见类型肠套叠的妥善管理。