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盲肠子宫内膜异位症继发肠套叠。

Intussusception secondary to endometriosis of the cecum.

作者信息

Katagiri Hideki, Lefor Alan Kawarai, Nakata Tetsuo, Matsuo Toshikazu, Shimokawa Isao

机构信息

Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-32, Todaijima, Urayasu City, Chiba 279-0001, Japan.

Department of Surgery, Jichi Medical University, 1-3311, Yakushiji, Shimotsuke City, Tochigi 329-0498, Japan.

出版信息

Int J Surg Case Rep. 2014;5(12):890-2. doi: 10.1016/j.ijscr.2014.10.047. Epub 2014 Oct 23.

Abstract

INTRODUCTION

Intussusception in adults is a rare cause of bowel obstruction. Endometriosis of the bowel is also a rare entity that can be the cause of bowel obstruction. Here, we report a rare case of intussusception secondary to endometriosis of the cecum.

PRESENTATION OF CASE

A 40-year-old woman presented to the hospital with a one-week history of intermittent epigastric pain. On physical examination, there was a soft, round non-tender palpable mass in the right flank and abdominal computed tomography scan revealed an intussusception. We made the diagnosis of ileo-colic intussusception and performed ileocecal resection. The surgical specimen revealed a round submucosal cystic mass in the cecum and the histology showed endometriosis of the cecum.

DISCUSSION

Intussusception in adults is a rare entity present in just 1% of all patients with bowel obstruction, and 5% of all intussusceptions. In general, intussusception in adults has a pathologic lesion as the lead point and the lesion is a malignancy in 20-50% of the cases. Thus, the treatment of an intussusception in adults should be operative. Endometriosis of the bowel is a rare cause of intussusception. Small endometriosis lesions of the bowel are unlikely to cause symptoms; however, in patients presenting with bowel obstruction, urgent treatment is indicated.

CONCLUSION

Intussusception in an adult is a rare cause of bowel obstruction and intussusception caused by endometriosis is also rare. Although rare, the diagnosis of endometriosis as a cause of intussusception must be considered as part of the differential diagnosis.

摘要

引言

成人肠套叠是肠梗阻的罕见病因。肠道子宫内膜异位症也是一种可导致肠梗阻的罕见病症。在此,我们报告一例罕见的因盲肠子宫内膜异位症继发肠套叠的病例。

病例介绍

一名40岁女性因间歇性上腹部疼痛一周前来就诊。体格检查时,右侧腹部可触及一个柔软、圆形、无压痛的肿块,腹部计算机断层扫描显示存在肠套叠。我们诊断为回结肠型肠套叠并进行了回盲部切除术。手术标本显示盲肠有一个圆形黏膜下囊性肿块,组织学检查显示为盲肠子宫内膜异位症。

讨论

成人肠套叠是一种罕见病症,仅占所有肠梗阻患者的1%,占所有肠套叠病例的5%。一般而言,成人肠套叠以病理性病变作为引导点,其中20% - 50%的病例病变为恶性肿瘤。因此,成人肠套叠的治疗应采取手术方式。肠道子宫内膜异位症是肠套叠的罕见病因。肠道内较小的子宫内膜异位症病变不太可能引起症状;然而,对于出现肠梗阻的患者,需要进行紧急治疗。

结论

成人肠套叠是肠梗阻的罕见病因,由子宫内膜异位症引起的肠套叠也很罕见。尽管罕见,但在鉴别诊断中必须考虑将子宫内膜异位症作为肠套叠的病因进行诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e71/4276274/f5d4a369362a/gr1.jpg

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