Gange Eliot R, Grieco Marco A, Myers Scott D, Guenther Timothy M
Department of Surgery, University of California Davis, Sacramento, CA 95817, USA.
Department of Radiology, David Grant USAF Medical Center, CA 95433, USA.
J Surg Case Rep. 2020 Dec 31;2020(12):rjaa542. doi: 10.1093/jscr/rjaa542. eCollection 2020 Dec.
Intussusception is uncommon among adults. The condition, which is defined as a telescoping of a proximal portion of the small or large bowel into the lumen of an adjacent segment of bowel, is most commonly seen in children. Among pediatric cases, the majority is benign and treated non-operatively. However, in adults, intussusception is the result of pathologic and often malignant lead points in the majority of cases. This makes surgical resection and tissue diagnosis the only definitive treatment option. While the majority of adult intussusception cases involves a pathologic lead point, a small percentage is idiopathic, without an identifiable lead point. We present a 32-year-old man with acute on chronic abdominal pain and cross-sectional imaging that identified jejunal intussusception, which was confirmed in operating room and resected. Interestingly, no pathologic lead point was identified on pathologic review. We discuss our diagnostic approach, surgical decision making and final tissue diagnosis.
肠套叠在成人中并不常见。这种情况被定义为小肠或大肠的近端部分套入相邻肠段的肠腔内，最常见于儿童。在儿科病例中，大多数是良性的，采用非手术治疗。然而，在成人中，大多数情况下肠套叠是由病理性且通常是恶性的引导点引起的。这使得手术切除和组织诊断成为唯一的确定性治疗选择。虽然大多数成人肠套叠病例涉及病理性引导点，但一小部分是特发性的，没有可识别的引导点。我们报告一名32岁男性，有急性慢性腹痛，经横断面成像发现空肠套叠，在手术室得到证实并进行了切除。有趣的是，病理检查未发现病理性引导点。我们讨论了我们的诊断方法、手术决策和最终的组织诊断。
