Zakaria Ali H, Daradkeh Salam
Istishari Hospital, The University of Jordan, P.O. Box 13261, Amman 11942, Jordan.
Case Rep Surg. 2012;2012:173680. doi: 10.1155/2012/173680. Epub 2012 Nov 19.
Background. Adult intussusception is a rare entity representing less than 1% of all intestinal obstructions. Diagnosis of the condition is difficult requiring a high index of suspicion and the utilization of imaging studies, especially CT scans. Diagnostic laparoscopy and/or exploratory laparotomy can be used as a diagnostic and therapeutic intervention. In over 90% of cases, an underlying lead point is identified. In the patient described here, it was a gastrointestinal stromal tumor (GIST), a relatively rare mesenchymal tumor comprising only 0.2-1.0% of the gastrointestinal tract neoplasms and believed to originate from neoplastic transformation of the interstitial cells of Cajal. GISTs may occur anywhere along the gastrointestinal tract, but most commonly arise in the stomach and small intestine. Literature review revealed only few cases reporting GISTs as a leading point of adult's intussusception. Case Presentation. In this report, we are presenting a rare case of jejunojejunal intussusception in a 78-year-old female patient with a GIST located in the terminal jejunum being the leading point, demonstrating the importance of imaging studies, especially CT scan, laparoscopy, and exploratory laparotomy as diagnostic and therapeutic interventions.
背景。成人肠套叠是一种罕见疾病,在所有肠梗阻病例中占比不到1%。该病的诊断较为困难,需要高度怀疑并利用影像学检查,尤其是CT扫描。诊断性腹腔镜检查和/或剖腹探查术可作为诊断和治疗手段。在超过90%的病例中,可发现潜在的引导点。在此描述的患者中,引导点是胃肠道间质瘤(GIST),这是一种相对罕见的间质性肿瘤,仅占胃肠道肿瘤的0.2 - 1.0%,被认为起源于 Cajal 间质细胞的肿瘤性转化。GIST可发生于胃肠道的任何部位,但最常见于胃和小肠。文献回顾显示,仅有少数病例报道GIST作为成人肠套叠的引导点。病例报告。在本报告中,我们呈现了一例罕见的空肠 - 空肠套叠病例,患者为一名78岁女性,末端空肠存在一个GIST作为引导点,展示了影像学检查,尤其是CT扫描、腹腔镜检查和剖腹探查术作为诊断和治疗手段的重要性。