Casiraghi Tiziana, Masetto Alessandro, Beltramo Massimo, Girlando Mauro, Di Bella Camillo
Azienda Socio-Sanitaria di Vimercate, Presidio di Carate, Via Mosè Bianchi 9, 20841 Carate Brianza, Italy.
Azienda Socio-Sanitaria di Vimercate, Presidio di Vimercate, Via Santi Cosma e Damiano 10, 20871 Vimercate, Italy.
Case Rep Surg. 2016;2016:3519606. doi: 10.1155/2016/3519606. Epub 2016 Dec 4.
. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions). Colonic intussusception is even rarer, particularly when caused by lipomas. . A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm) was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. . Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%); since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.
肠套叠在成人中是一种罕见的临床病症（占肠梗阻的比例小于1%）。结肠套叠更为罕见，尤其是由脂肪瘤引起时。一名47岁女性因腹痛伴呕吐和腹泻就诊于我院急诊科。X线和CT显示因回结肠和结肠结肠套叠导致肠梗阻；在结肠脾曲远侧可立即识别出一个巨大的结肠脂肪瘤（9×4×4厘米）。患者接受了急诊剖腹手术和右半结肠切除术。对切除标本的评估证实了靠近回盲瓣处存在巨大结肠息肉样病变，导致12厘米长的肠套叠并伴有中度缺血性损伤。脂肪瘤引起的肠套叠导致的结肠梗阻是一种非常罕见的病症，需要紧急治疗。CT是诊断的首选影像学检查方法（敏感性80%，特异性接近100%）；由于大多数结肠套叠是由原发性腺癌引起的，如果病因不确定，该病变必须被解释为恶性，建议进行广泛切除。目前，手术是首选治疗方法，且预后良好。
