Kobayashi Kenta, Yabe Sakiko, Hijikata Kohei, Masuda Taiki, Kakimoto Masaki, Hoshino Mayumi, Goto Hiroshi, Koshiishi Haruya, Yoshimura Tetsunori
Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hospital.
Gan To Kagaku Ryoho. 2016 Nov;43(12):1857-1859.
A 67-year-old female with abdominal pain and vomiting was admitted to our hospital. Abdominal X-ray showed dilated small bowel in the left upper abdomen. She was diagnosed with ileocecal intussusception based on abdominal contrastenhanced computed tomography. Computed tomography showed a "pseudo kidney sign" in the right flank region. We also observed an enhanced mass lesion in the presenting portion ofthe intussusception. Laparotomy was performed to treat the invagination. We tried to reduce the invagination, without success. Ileocecal resection was performed. Pathological findings revealed that poorly differentiated adenocarcinoma in the ileum end portion had induced the invagination. Intussusception in adults should be treated with the knowledge that about 80% ofsuch cases have an organic lesion in the presenting portion.
一名67岁腹痛伴呕吐的女性被收治入院。腹部X线显示左上腹小肠扩张。基于腹部增强计算机断层扫描，她被诊断为回盲部肠套叠。计算机断层扫描显示右侧胁腹区域有“假肾征”。我们还在肠套叠的套入部观察到一个强化的肿块病变。行剖腹手术治疗肠套叠。我们试图复位肠套叠，但未成功。遂行回盲部切除术。病理结果显示，回肠末端低分化腺癌引发了肠套叠。成人肠套叠的治疗应基于这样的认识，即此类病例中约80%在套入部存在器质性病变。
