De Robles Marie Shella, O'Neill Robert Sean, Young Christopher J
Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
School of Medicine, University of Notre Dame, Darlinghurst, Australia.
Int J Surg Case Rep. 2020;70:126-129. doi: 10.1016/j.ijscr.2020.04.010. Epub 2020 May 8.
Adult intussusception (AI) is both a challenging and rare diagnosis, with predisposing factors including malignancy, surgery and infection to name a few. Transient jejunal intussusception is a subset of AI which is usually diagnosed radiologically, with diagnostic laparoscopy utilised to determine whether a malignant cause is identifiable and subsequently treatable.
We present the case of a previously healthy 36-year-old male diagnosed with transient jejunal intussusception on computed tomography after presenting with abdominal pain. Blood tests on admission were normal apart from polycythaemia. His only significant history was that of chronic anabolic steroid use. He had a subsequent normal gastroscopy and colonoscopy with diagnostic laparoscopy demonstrating thickening of the small bowel. Histopathological analysis of the intraoperative specimen was normal. The patient improved and was discharged with no further complications.
This case highlights the potential association between anabolic steroid use resulting in polycythaemia, and AI or transient jejunal intussusception, along with further validating a conservative approach in the management of AI in patients deemed to be low risk of malignancy on pre-operative evaluation.
成人肠套叠(AI)是一种具有挑战性的罕见诊断,其诱发因素包括恶性肿瘤、手术和感染等。短暂性空肠套叠是AI的一个子集,通常通过放射学诊断,利用诊断性腹腔镜检查来确定是否可识别并随后治疗恶性病因。
我们报告一例病例,一名36岁既往健康男性,因腹痛就诊,计算机断层扫描诊断为短暂性空肠套叠。入院时血液检查除红细胞增多症外均正常。他唯一重要的病史是长期使用合成代谢类固醇。随后他接受了正常的胃镜和结肠镜检查,诊断性腹腔镜检查显示小肠增厚。术中标本的组织病理学分析正常。患者病情好转并出院,无进一步并发症。
该病例突出了使用合成代谢类固醇导致红细胞增多症与AI或短暂性空肠套叠之间的潜在关联,同时进一步验证了对于术前评估被认为恶性风险较低的AI患者采用保守治疗方法的合理性。