Mousa Hussam M, Al-Salam Suhail, Abu-Zidan Fikri M
Department of Surgery, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates; Department of Surgery, Al Ain Hospital, Al Ain, United Arab Emirates.
Department of Pathology, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
Int J Surg Case Rep. 2019;59:197-200. doi: 10.1016/j.ijscr.2019.05.043. Epub 2019 May 31.
Angiomyxoma-related intussusception in adults is extremely rare. Herein, we report an adult man who presented with mechanical small bowel obstruction caused by ileo-colic intussusception triggered by an angiomyxoma of the terminal ileum and review the literature on this topic.
A-40-year-old man was referred to Al-Ain Hospital with a clinical picture of small bowel obstruction. He has no previous abdominal surgery. Clinical examination showed a distended soft abdomen, and hyperactive bowel sounds. Abdominal ultrasound and computed tomography scan showed a doughnut sign confirming the presence of ileo-colic intussusception as the cause for small bowel obstruction. At laparotomy, a mass was found in the right iliac fossa. Right hemi colectomy was performed with ileo-colic anastomosis. An ileal pedunculated mass triggered the intussusception. Histopathology of the mass was diagnostic of an angiomyxoma of small bowel. Echocardiogram showed no atrial synchronous myxoma. The patient was discharged home with good general condition. At three years follow up, the patient remained asymptomatic without evidence of recurrence.
Myxoma of small bowel should be included in the differential diagnosis of small bowel obstruction in the young age group particularly if the diagnosis of intussusception was made preoperatively.
成人血管黏液瘤相关的肠套叠极为罕见。在此,我们报告一名成年男性,他因回肠末端血管黏液瘤引发回结肠套叠导致机械性小肠梗阻,并对该主题的文献进行回顾。
一名40岁男性因小肠梗阻的临床表现被转诊至艾因医院。他既往无腹部手术史。临床检查显示腹部柔软膨隆,肠鸣音亢进。腹部超声和计算机断层扫描显示“甜甜圈征”,证实回结肠套叠是小肠梗阻的病因。剖腹手术时,在右髂窝发现一个肿块。行右半结肠切除术并进行回结肠吻合术。一个带蒂的回肠肿块引发了肠套叠。肿块的组织病理学诊断为小肠血管黏液瘤。超声心动图显示无心房同步黏液瘤。患者出院时一般情况良好。随访三年,患者无症状,无复发迹象。
小肠黏液瘤应纳入年轻年龄组小肠梗阻的鉴别诊断,尤其是术前已诊断为肠套叠的情况。