Poynter L R, Tewari N, Khawaja H T
Medway NHS Foundation Trust, Gillingham, London, UK.
BMJ Case Rep. 2011 Mar 8;2011:bcr1120103530. doi: 10.1136/bcr.11.2010.3530.
This report describes an acute presentation of obstructive jaundice, with a clinical picture of cholecystitis. A primary carcinoid tumour in the terminal ileum with hepatic secondaries was found to be the cause. Additionally, in the terminal ileum was a closely associated lipoma leading to an ileo-caecal intussusception. There are few such cases in the literature, particularly in the absence of any changes in bowel habit or lower abdominal pain. The majority of cases of intussusception in clinical practice occur in the paediatric population. Of the small numbers (<5%) that occur in adulthood, the underlying aetiology is most commonly a primary adenocarcinoma, with a far smaller number being attributable to lipoma, lymphoma and polyps.
本报告描述了一例以胆囊炎临床表现急性呈现的梗阻性黄疸病例。发现病因是回肠末端的原发性类癌肿瘤伴肝转移。此外，在回肠末端有一个紧密相连的脂肪瘤，导致回盲部肠套叠。文献中此类病例很少，尤其是在没有任何排便习惯改变或下腹痛的情况下。临床实践中大多数肠套叠病例发生在儿童群体。在成年期发生的少数病例（<5%）中，潜在病因最常见的是原发性腺癌，归因于脂肪瘤、淋巴瘤和息肉的病例数量要少得多。
