Kimura Sota, Iida Hiroyuki, Gunji Naoto, Gohongi Takeshi, Ogata Takesaburo
Department of Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan.
Department of Pathology, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan.
Surg Case Rep. 2018 Sep 15;4(1):116. doi: 10.1186/s40792-018-0527-z.
Intestinal duplication, a congenital malformation, is considered a rare condition, particularly in adults. Although it affects young children, a minority of patients remains asymptomatic until adulthood. Here, we describe a case of an intestinal duplication cyst that caused intussusception by a unique mechanism.
A 19-year-old man was admitted to our hospital for intermittent abdominal pain. Computed tomography revealed colonic intussusception induced by a nodular mass in the ileocecal region. Urgent ileocecal resection was performed because of the risk of colonic ischemia. The resected material comprised a stool-filled noncommunicating cyst that protruded into the enteric lumen at the ileocecal valve. Histological analyses revealed that the inner wall of the cyst was lined with colonic mucosa and that the muscle layer of the cyst was shared with that of the original enteric wall; furthermore, the cyst had a vestige of an opening site in the wall. We concluded that the cyst was an intestinal duplication that poured stool into its lumen through the tiny orifice, thereby triggering intussusception.
The present case suggests that stool-pouring can cause intussusception into the space of an intestinal duplication lesion.
肠道重复畸形是一种先天性畸形，被认为是一种罕见疾病，尤其是在成人中。虽然它会影响幼儿，但少数患者直到成年仍无症状。在此，我们描述一例肠道重复畸形囊肿通过独特机制导致肠套叠的病例。
一名19岁男性因间歇性腹痛入院。计算机断层扫描显示回盲部的结节状肿块导致结肠套叠。由于存在结肠缺血风险，遂行急诊回盲部切除术。切除的标本为一个充满粪便的非交通性囊肿，该囊肿在回盲瓣处突入肠腔。组织学分析显示，囊肿内壁衬有结肠黏膜，囊肿的肌层与原肠壁的肌层相连；此外，囊肿壁上有一个开口部位的遗迹。我们得出结论，该囊肿是一个肠道重复畸形，粪便通过微小的孔口进入其腔内，从而引发肠套叠。
本病例提示，粪便灌入可导致肠套叠进入肠道重复畸形病变的空间。
