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伪装成肠套叠的神经内分泌肿瘤:一例报告。

Neuroendocrine tumour masquerading as intussusception: A case report.

作者信息

Wong Lingwei, Kanthasamy Senthil Vasan, Durairaj Gunaseelan, Thangaratnam Ramesh R

机构信息

Hospital Serdang, Selangor, Malaysia; University of Malaya, Kuala Lumpur, Malaysia.

Hospital Serdang, Jalan Puchong, 43000, Kajang, Selangor Darul Ehsan, Malaysia.

出版信息

Int J Surg Case Rep. 2020;77:48-52. doi: 10.1016/j.ijscr.2020.10.091. Epub 2020 Oct 24.

Abstract

INTRODUCTION

Intussusception usually occurs in the paediatric population. When it occurs in the adult population, it is normally caused by a malignant intraluminal pathology.

PRESENTATION OF CASE

A 72-year-old female presented to us with right-sided abdominal pain for 3 weeks, associated with vomiting and diarrhoea. She had an appendectomy done 30 years ago and a recent myocardial infarction. Abdominal examination revealed a previous appendectomy scar and tenderness over the right lumbar region. Computed tomography showed ileocaecal intussusception. Right hemicolectomy with a double barrel stoma was performed as she was unstable intraoperatively. Histopathological examination of the tumour showed a well-differentiated neuroendocrine tumour. Subsequent PET scan showed no systemic disease and a reversal of the stoma was done. She remained disease free for a year.

DISCUSSION

Our patient had undergone a right hemicolectomy despite the high risk of mortality, as there is a high chance of malignancy. Double barrel stoma was done, as she was unstable intraoperatively. Fortunately, she recovered well and had her stoma reversed without any further recurrence of her disease.

CONCLUSION

Adult patients who present with intussusception should be managed with resection, as there is a high possibility of a malignancy. Early resection should be planned to prevent further spread of the tumour.

摘要

引言

肠套叠通常发生于儿童群体。当发生在成人身上时,通常由腔内恶性病变引起。

病例介绍

一名72岁女性因右侧腹痛3周前来就诊,伴有呕吐和腹泻。她30年前做过阑尾切除术,近期发生过心肌梗死。腹部检查发现有阑尾切除术后瘢痕,右侧腰部有压痛。计算机断层扫描显示回盲部肠套叠。由于术中情况不稳定,遂行右半结肠切除术并做了双腔造口术。肿瘤组织病理学检查显示为高分化神经内分泌肿瘤。随后的正电子发射断层扫描显示无全身疾病,于是进行了造口还纳术。她一年内无疾病复发。

讨论

尽管死亡率高,但我们的患者仍接受了右半结肠切除术,因为恶性肿瘤的可能性很大。由于术中情况不稳定,所以做了双腔造口术。幸运的是,她恢复良好,造口还纳,疾病未再复发。

结论

出现肠套叠的成年患者应接受切除术治疗,因为恶性肿瘤的可能性很大。应计划尽早切除,以防止肿瘤进一步扩散。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c9a/7610031/cda8552b229c/gr1.jpg

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