Kim Kyungjoong, Ko Myungkwan, Sim Ho Chan, Kim Chang Lae, Jung Yeo Jin, Kim Tae Oh
Division of Gastroenterology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
Korean J Gastroenterol. 2019 Jun 25;73(6):355-359. doi: 10.4166/kjg.2019.73.6.355.
Intussusception is a common in pediatric age group. But it is rare in adults. And intussusception caused by tumor account for 1% of bowel obstructions in adult. Intussusception is an extremely rare cause of abdominal pain in pregnancy. In particular, cases of Intussusception due to colorectal cancer during pregnancy have never been reported in Korea. Our patient is a 34 years old woman who presented at 14 weeks of her second pregnancy. She presented with right lower abdominal discomfort and intermittent palpable mass which was usually spontaneously resolved. In the MRI study, pathologic asymmetric wall thickening was still noted and ileocolic intussusception was noted, and in colonoscopy, there was ulcerofungating mass around ileocecal valve which may be a leading point of intussusception. Biopsy was done. Pathologic finding was poorly differentiated adenocarcinoma. Under the patient agreement, we performed dilatation and curettage and laparoscopic right hemicolectomy and lymph node dissection. Now she is receiving a FOLFOX chemotherapy.
肠套叠在儿童年龄组中很常见。但在成人中很少见。由肿瘤引起的肠套叠占成人肠梗阻的1%。肠套叠是孕期腹痛极其罕见的原因。特别是,韩国从未报道过孕期因结直肠癌导致肠套叠的病例。我们的患者是一名34岁女性,在其第二次怀孕14周时就诊。她表现为右下腹不适和间歇性可触及肿块,肿块通常会自行消退。在MRI检查中,仍发现病理性不对称肠壁增厚,并发现回结肠套叠,在结肠镜检查中,回盲瓣周围有溃疡性蕈伞状肿块,这可能是肠套叠的起始点。进行了活检。病理结果为低分化腺癌。在患者同意下,我们进行了刮宫术、腹腔镜右半结肠切除术和淋巴结清扫术。现在她正在接受FOLFOX化疗。