Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan.
World J Gastroenterol. 2017 Sep 21;23(35):6534-6539. doi: 10.3748/wjg.v23.i35.6534.
A 27-year-old man with recurrent right lower quadrant pain was admitted to our hospital. Ultrasonography and computed tomography examination of the abdomen revealed a target sign in the ascending colon, which was compatible with the diagnosis of cecal intussusception. The intussusception was spontaneously resolved at that time, but it relapsed 6 mo later. The patient underwent a successful colonoscopic disinvagination; there was no evidence of neoplastic or inflammatory lesions in the colon and terminal ileum. The patient underwent laparoscopic surgery for recurring cecal intussusception. During laparoscopy, we observed an unfixed cecum on the posterior peritoneum (i.e. a mobile cecum). Thus, we performed laparoscopic appendectomy and cecopexy with a lateral peritoneal flap using a barbed wound suture device. The patient's post-operative course was uneventful, and he continued to do well without recurrence at 10 mo after surgery. Laparoscopic cecopexy using a barbed wound suture device is a simple and reliable procedure that can be the treatment of choice for recurrent cecal intussusception associated with a mobile cecum.
一位 27 岁男性，反复右下腹痛，就诊于我院。腹部超声和 CT 检查提示升结肠靶环征，符合盲肠套叠诊断。当时套叠自行复位，但 6 个月后再次复发。患者接受了成功的结肠镜下复位术，结肠镜检查未见结肠和末端回肠有肿瘤或炎症性病变。患者因反复发生的盲肠套叠行腹腔镜手术。术中观察到后腹膜上的盲肠不固定（即盲肠活动度大），遂使用带倒刺缝线的缝合装置行腹腔镜阑尾切除术和侧腹膜瓣盲肠固定术。患者术后恢复顺利，无并发症，术后 10 个月无复发，恢复良好。使用带倒刺缝线的缝合装置行腹腔镜盲肠固定术是一种简单可靠的术式，对于与盲肠活动度大相关的复发性盲肠套叠，可作为首选治疗方法。
