Imasato Mitsunobu, Kim Ho Min, Higashi Shigeyoshi, Kajihara Jun, Hatano Hisanori, Demura Koichi, Iiboshi Yasuhiko, Ito Toshikazu
Department of Surgery, Rinku General Medical Center, Osaka, Japan.
Department of Surgery, Osaka Police Hospital, Osaka, Japan.
J Anus Rectum Colon. 2019 Jan 29;3(1):49-52. doi: 10.23922/jarc.2018-021. eCollection 2019.
Most cases of adult intussusception are caused by neoplastic lesions, and idiopathic adult intussusception is very rare. We present a case in which laparoscopic surgery was performed for idiopathic adult intussusception initially reduced by colonoscopy. A 53-year-old woman presented to the emergency department of our hospital with intermittent lower abdominal pain. Contrast-enhanced computed tomography and ultrasonography of the abdomen showed a concentric structure in the ascending colon. We diagnosed intussusception. Colonoscopy achieved successful reduction before surgery. Twelve days after this reduction, laparoscopic surgery was performed. Histopathological examination did not reveal any causative pathology; therefore, idiopathic adult intussusception was diagnosed. The postoperative course was uneventful, and the patient was discharged on postoperative day 14. Preoperative colonoscopy should be utilized to diagnose the main lesion and may be useful for reducing adult intussusception. Laparoscopic surgery is both minimally invasive and safe and can be performed following endoscopic reduction.
大多数成人肠套叠病例由肿瘤性病变引起，特发性成人肠套叠非常罕见。我们报告一例最初通过结肠镜检查复位的特发性成人肠套叠患者接受腹腔镜手术的病例。一名53岁女性因间歇性下腹痛就诊于我院急诊科。腹部增强计算机断层扫描和超声检查显示升结肠有同心结构。我们诊断为肠套叠。结肠镜检查在手术前成功复位。复位后12天进行了腹腔镜手术。组织病理学检查未发现任何致病病理；因此，诊断为特发性成人肠套叠。术后病程顺利，患者于术后第14天出院。术前结肠镜检查应用于诊断主要病变，可能有助于复位成人肠套叠。腹腔镜手术微创且安全，可在内镜复位后进行。
