Paramythiotis D, Goulas P, Moysidis M, Papavramidis T, Michalopoulos A
1 Propaedeutic Surgical Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece.
Hippokratia. 2019 Jan-Mar;23(1):37-41.
Bowel intussusception in adults remains a rare and constant diagnostic challenge for surgeons. It has an incidence of around 2-3 new cases per million per year, and its primary cause is benign or malignant neoplasms of the small bowel and colon. This report aims to outline the importance of high clinical suspicion regarding intussusception in adults presenting with abdominal pain in the emergency department. Case report: This is a retrospective review of three cases of adult ileocecal intussusception that were treated in a single surgical department in three years (2015-2018). All patients underwent right hemicolectomy in keeping with the principles of surgical oncology. Each patient had a different clinical presentation, while, in terms of the underlining pathology, the first had an adenocarcinoma of the ascending colon, the second an adenocarcinoma of the ileocecal valve, and the third one an inflammatory fibroid polyp of the ileocecal valve, also known as Vanek's tumor.
Large bowel intussusception in adults is quite an interesting entity, not only for its rarity but for its non-specific and atypical clinical presentation as well. High suspicion from the clinician's part and availability of a computed tomography scan is the key to diagnosis. It is not unusual for imaging modalities to be unable to identify the cause of the intussusception. Thus, surgery is always the preferred method of treatment, as, more often than not, a neoplasm of the small or the large bowel is the underlining pathology. HIPPOKRATIA 2019, 23(1): 37-41.
成人肠套叠对外科医生来说仍然是一种罕见且始终具有诊断挑战性的疾病。其发病率约为每年每百万人口中有2 - 3例新发病例，其主要病因是小肠和结肠的良性或恶性肿瘤。本报告旨在概述在急诊科对出现腹痛的成人肠套叠保持高度临床怀疑的重要性。病例报告：这是对三年（2015 - 2018年）内在单个外科科室接受治疗的三例成人回盲部肠套叠病例的回顾性研究。所有患者均按照外科肿瘤学原则接受了右半结肠切除术。每位患者的临床表现各异，而就潜在病理而言，第一例为升结肠癌，第二例为回盲瓣腺癌，第三例为回盲瓣炎性纤维瘤息肉，也称为瓦内克瘤。
成人大肠套叠是一个相当有趣的疾病实体，不仅因其罕见，还因其非特异性和非典型临床表现。临床医生的高度怀疑以及计算机断层扫描的可用性是诊断的关键。成像方式无法识别肠套叠病因的情况并不少见。因此，手术始终是首选的治疗方法，因为通常情况下，小肠或大肠肿瘤是潜在的病理原因。《希波克拉底》2019年，第23卷第1期：37 - 41页。
