Esnakula Ashwini K, Sinha Archana, Fidelia-Lambert Marie, Tammana Venkata S
Department of Pathology, Howard University Hospital, Washington, DC, USA.
BMJ Case Rep. 2013 Mar 26;2013:bcr2013008921. doi: 10.1136/bcr-2013-008921.
Intussusception in adults is rare and more common in the paediatric population. Clinically, most adult patients have chronic non-specific symptoms due to partial obstruction. In contrast, most paediatric patients present with the classic triad of abdominal pain, vomiting and blood in stool. Adult intussusception is commonly associated with an organic aetiology, most likely a benign or malignant neoplasm as a lead point of intussusception. We describe a case of a 29-year-old woman with subacute presentation due to ileoileal intussusception secondary to a polypoid submucosal angiolipoma. Angiolipoma is a benign lesion composed of mature adipose tissue and thin-walled capillaries. The presence of thin-walled vessels differentiates it from a lipoma. Angiolipomas of the small intestine are extremely rare with very few reported cases. This case not only demonstrates an unusual benign lesion as a cause of intussusception, but also illustrates an atypical clinical presentation in adults with intussusception.
成人肠套叠较为罕见,在儿科人群中更为常见。临床上,大多数成年患者因部分梗阻而出现慢性非特异性症状。相比之下,大多数儿科患者表现为腹痛、呕吐和便血这一典型三联征。成人肠套叠通常与器质性病因相关,最有可能是作为肠套叠引导点的良性或恶性肿瘤。我们描述了一例29岁女性患者,因息肉样黏膜下血管脂肪瘤继发回肠-回肠套叠而出现亚急性表现。血管脂肪瘤是一种由成熟脂肪组织和薄壁毛细血管组成的良性病变。薄壁血管的存在使其有别于脂肪瘤。小肠血管脂肪瘤极为罕见,报道的病例很少。该病例不仅显示了一种不寻常的良性病变作为肠套叠的病因,还说明了成人肠套叠的非典型临床表现。