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成人回肠-回肠型肠套叠:炎性纤维瘤性息肉致 1 例报告。

Adult Ileo-ileal Intussusception Due to Inflammatory Fibroid Polyp: A Case Report.

机构信息

Department of gastroenterological surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.

出版信息

Tokai J Exp Clin Med. 2020 Dec 20;45(4):202-206.

Abstract

INTRODUCTION

Intussusception occurs when one part of the intestines slides into the adjacent intestine resulting in bowel obstruction. It is a rare condition in adults, accounting for only 5% of all intussusceptions. It has multiple causes, with inflammatory fibroid polyps (IFPs) very infrequently being the cause. We present a rare case of intussusception in an adult due to an IFP.

CASE PRESENTATION

A 72-year-old woman visited our hospital complaining of abdominal pain. Abdominal contrast-enhanced computed tomography (CT) demonstrated an ileo-ileal intussusception due to a round mass. An emergency surgery involving a partial ileal resection with laparoscopic assistance was performed. Pathological findings of the tumor showed proliferation of spindle-shaped cells, edematous stroma, dilation of lymphatic vessels, and infiltration of inflammatory cells, which were mainly eosinophils. Immunohistochemistry was positive for vimentin and SMA and negative for CD117, CD34, S-100, and desmin. Based on these findings, the tumor was diagnosed as an IFP.

CONCLUSION

Bowel obstruction in adults due to intussusception is rare, and those due to IFPs are even more rare. Preoperative diagnosis of IFP is difficult, but surgeons must keep in mind that it can be a cause of adult intussusception.

摘要

介绍

肠套叠是指一段肠管套入其相连的肠管腔内,导致肠梗阻。成人肠套叠较为少见,仅占所有肠套叠的 5%。其病因多样,炎性纤维瘤性息肉(IFP)很少是其病因。我们报告一例罕见的成人 IFP 导致的肠套叠病例。

病例介绍

一名 72 岁女性因腹痛就诊于我院。腹部增强 CT 显示回肠-回肠套叠,由一圆形肿块引起。行急诊手术,在腹腔镜辅助下进行部分回肠切除术。肿瘤的病理发现显示梭形细胞增生,水肿性基质,淋巴管扩张和炎症细胞浸润,主要为嗜酸性粒细胞。免疫组化显示波形蛋白和 SMA 阳性,CD117、CD34、S-100 和结蛋白阴性。根据这些发现,诊断为 IFP。

结论

成人肠套叠导致肠梗阻较为少见,而 IFP 导致的则更为罕见。术前诊断 IFP 较为困难,但外科医生必须牢记,它可能是成人肠套叠的病因之一。

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