Khan Khuram, Kleess Lauren, Ganga Ram, DePaz Hector, Santopietro Robert
Department of Surgery, Harlem Hospital Center, Columbia University, New York, USA.
Department of Surgery, Montefiore New Rochelle Hospital, New York, USA.
Int J Surg Case Rep. 2017 Nov 21;41:469-472. doi: 10.1016/j.ijscr.2017.11.033. eCollection 2017.
Lymphangioma is a rare benign tumor found in gastrointestinal tract. Most lymphangiomas can occur at any age and but mostly are found in children and infants. They are mainly due to malformation of the lymphatic system. They occur mainly in the head, neck and oral cavity, but less commonly develop in the abdominal cavity. Colonoscopy and endoscopic ultrasonography are frequently used to diagnose lymphangiomas of the small bowel. Ileo-ileal intussusception due to small bowel lymphangiomas has been rarely reported.
We report a case of 24 year old female who presented to the hospital with sudden onset of right sided upper and lower abominal pain with nausea and vomiting, elevated WBC count of 15.1 μL. After careful examination and CT scan of Abdomen patient was found to have an ileo-ileal intussusception secondary to small bowel lymphangioma. In a rare clinical presented case, we performed a diagnostic laparoscopy (Fig. 1), exploratory laparotomy, small bowel resection, and stable primary anastomosis. Post-operative patient did well and was discharged on 4th post-operative day without complications.
Lymphangiomas are rare benign tumors which have soft tissue consistency and often congenital malformation of the lymphatic system. Ileo-ileal intussusception in an adults can be a life threatening condition which requires prompt diagnosis and urgent intervention due to the risk of developing ischemic bowel. Prompt diagnosis and urgent intervention can lead to favourable.
We present this rare case of ileo-ileal intussusception secondary to small bowel lymphangioma with literature review.
淋巴管瘤是一种罕见的胃肠道良性肿瘤。大多数淋巴管瘤可发生于任何年龄，但多见于儿童和婴儿。它们主要是由于淋巴系统畸形所致。主要发生在头、颈和口腔，但较少发生在腹腔。结肠镜检查和内镜超声检查常用于诊断小肠淋巴管瘤。小肠淋巴管瘤导致回肠套叠的情况鲜有报道。
我们报告一例24岁女性患者，因突发右上腹和右下腹疼痛伴恶心、呕吐入院，白细胞计数升高至15.1μL。经仔细检查和腹部CT扫描，发现患者因小肠淋巴管瘤继发回肠套叠。在这例罕见的临床病例中，我们进行了诊断性腹腔镜检查（图1）、剖腹探查、小肠切除及一期吻合术，手术顺利。术后患者恢复良好，术后第4天出院，无并发症。
淋巴管瘤是罕见的良性肿瘤，质地柔软，常为淋巴系统先天性畸形。成人回肠套叠可能危及生命，由于存在发生缺血性肠病的风险，需要及时诊断和紧急干预。及时诊断和紧急干预可带来良好预后。
我们通过文献回顾，呈现了这例罕见的小肠淋巴管瘤继发回肠套叠病例。
