Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de la Princesa, Madrid, Spain.
Dis Colon Rectum. 2021 Jun 1;64(4):645-648. doi: 10.1097/DCR.0000000000002045.
A 37-year-old woman with no relevant past medical history presented to the emergency department after a 2-day-long period of crampy abdominal pain with an inability for oral intake because of persistent vomiting. The physical examination was unremarkable. Abdominal CT scan with water-soluble oral contrast revealed an ileocecal intussusception (Fig. 1). Because the patient was hemodynamically stable and no abdominal tenderness was found, a delayed surgical intervention was planned with laparoscopic approach. During intervention, the intestinal invagination was reduced, a cecal neoplasm suspected, and a right hemicolectomy with complete mesocolic excision was performed (Fig. 2). Postoperative recovery was uneventful, with discharge on postoperative day 5. The definite pathological report showed well-differentiated colon adenocarcinoma pT2N1aMx, with 1 of 49 positive lymph nodes.
一位 37 岁的女性,既往无相关病史,因持续性呕吐导致腹痛痉挛 2 天不能进食而到急诊就诊。体格检查无明显异常。腹部 CT 扫描加水溶性口服对比剂显示回盲部肠套叠(图 1)。由于患者血流动力学稳定,且未发现腹部压痛,计划行腹腔镜延迟手术干预。在干预过程中,肠套叠复位,怀疑回盲部有肿瘤,并进行了右半结肠切除术伴完整结肠系膜切除术(图 2)。术后恢复顺利,术后第 5 天出院。明确的病理报告显示分化良好的结肠腺癌 pT2N1aMx,有 1 个 49 个阳性淋巴结。