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成人回肠-回肠套叠的罕见病因

An Unusual Cause of Adult Ileoileal Intussusception.

作者信息

Javid Mohamed, Swaminathan Shanthi Ponnandai, Mani Rajeswari, Jebasingh Arun Victor

机构信息

Institute of General Surgery, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.

出版信息

J Glob Infect Dis. 2020 Nov 30;12(4):228-230. doi: 10.4103/jgid.jgid_115_20. eCollection 2020 Oct-Dec.

Abstract

Intestinal intussusception in adults is not considered to be common. Clinical presentations may range from an acute presentation to a chronic one and such wide variations make it challenging to establish the diagnosis on time. Adult intussusceptions usually have an identifiable pathological lead point: commonly a polyp, submucosal lipoma, or other tumors. Our patient, a 42-year-old male, presented to us with features of acute intestinal obstruction. He underwent an emergency laparotomy when intussusception of the ileum was noted; the involved bowel segment was resected. Histopathology showed that the lead point was due to tuberculous lesion. Further investigations showed that the patient had pulmonary tuberculosis (TB), which was not identified till then. The patient was started on antituberculous treatment thereafter and the patient recovered well. We intend to present this case to sensitize the readers to the unusual presentation of intestinal TB as intussusception which should be considered especially in countries with high TB endemicity.

摘要

成人肠套叠并不被认为常见。临床表现可能从急性表现到慢性表现不等,如此广泛的差异使得及时做出诊断具有挑战性。成人肠套叠通常有一个可识别的病理引导点:常见的是息肉、黏膜下脂肪瘤或其他肿瘤。我们的患者是一名42岁男性,因急性肠梗阻症状前来就诊。当发现回肠套叠时,他接受了急诊剖腹手术;切除了受累肠段。组织病理学显示引导点是由结核病变引起的。进一步检查表明患者患有肺结核,此前未被发现。此后患者开始接受抗结核治疗,恢复良好。我们打算展示这个病例,以使读者对肠结核以肠套叠这种不寻常的表现形式有所认识,尤其是在结核病高发地区更应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6014/8045545/76c5cdbef0c6/JGID-12-228-g001.jpg

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