Štor Zdravko, Hanžel Jurij
Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloška 7, SI-1525 Ljubljana, Slovenia.
J Surg Case Rep. 2019 Feb 19;2019(2):rjz052. doi: 10.1093/jscr/rjz052. eCollection 2019 Feb.
Intussusception is a rare cause of small bowel obstruction in adults, up to 30% of cases are caused by small bowel malignancy. Intestinal leiomyosarcoma is an extremely rare malignant mesenchymal tumour. An 80-year-old male presented with small bowel obstruction. Abdominal ultrasonography and a subsequent CT scan showed small bowel obstruction due to ileo-ileal intussusception. The patient underwent an emergency exploratory laparotomy, which confirmed prior findings on imaging. The affected segment of the ileum was resected and a primary entero-enteral anastomosis was created. Histopathological analysis revealed a 4.8 cm leiomyosarcoma. The patient remains without evidence of disease 12 months after initial presentation. Radical surgical resection remains the treatment of choice for leiomyosarcoma, with no convincing evidence supporting adjuvant treatment. Tumours smaller than 5 cm appear to have a more favourable prognosis.
肠套叠是成人小肠梗阻的罕见原因，高达30%的病例由小肠恶性肿瘤引起。肠道平滑肌肉瘤是一种极其罕见的恶性间叶肿瘤。一名80岁男性因小肠梗阻就诊。腹部超声及随后的CT扫描显示因回肠-回肠套叠导致小肠梗阻。患者接受了急诊剖腹探查术，术中所见证实了影像学检查结果。切除了受累的回肠段并进行了一期肠-肠吻合术。组织病理学分析显示为4.8厘米的平滑肌肉瘤。患者在初次就诊12个月后仍无疾病迹象。根治性手术切除仍然是平滑肌肉瘤的首选治疗方法，尚无令人信服的证据支持辅助治疗。小于5厘米的肿瘤似乎预后更佳。
