Lasithiotakis Konstantinos, Grisbolaki Evangelia, Filis Dimitrios, Athanasakis Ilias, Zoras Odysseas, Chalkiadakis George
Department of General Surgery, University Hospital of Heraklion, Crete, Greece.
Surg Laparosc Endosc Percutan Tech. 2012 Jun;22(3):e161-3. doi: 10.1097/SLE.0b013e31824b230f.
Only 5% of all cases of intussusceptions occur in adults. Intussusception complicating colonoscopy is an extremely rare event. Herein, we present a case of a 58-year-old man who developed ileocolic intussusception after a colonoscopy during which an adenomatous polyp was discovered in the terminal ileum. Eight hours after colonoscopy, the patient developed diffuse abdominal pain associated with vomiting and bloody diarrhea. A contrast-enhanced abdominal computed tomography scan revealed features of mechanical intestinal obstruction and a round soft tissue mass inside the right colon, followed by the wall of the intussusceptum. Emergency laparotomy revealed extended ileocecal intussusception with the polyp incarcerated by the ileocecal valve. A typical right hemicolectomy was performed, and the patient had an uneventful recovery. Histologic examination of the surgical specimen revealed an inflammatory fibroid polyp. Ileocolic intussusception due to an ileal polyp may be precipitated by colonoscopy and should be included in the differential diagnosis of acute abdomen after colonoscopy.
所有肠套叠病例中仅5%发生于成人。结肠镜检查并发肠套叠是极其罕见的事件。在此,我们报告一例58岁男性,其在结肠镜检查过程中发现回肠末端有一个腺瘤性息肉,之后发生了回结肠型肠套叠。结肠镜检查8小时后,患者出现弥漫性腹痛,伴有呕吐和血性腹泻。腹部增强计算机断层扫描显示机械性肠梗阻的特征以及右结肠内有一个圆形软组织肿块,随后是套叠肠壁。急诊剖腹探查显示广泛性回盲部肠套叠,息肉被回盲瓣嵌顿。实施了典型的右半结肠切除术,患者恢复顺利。手术标本的组织学检查显示为炎性纤维瘤性息肉。回肠息肉导致的回结肠型肠套叠可能由结肠镜检查诱发,应列入结肠镜检查后急腹症的鉴别诊断中。