Tarchouli Mohamed, Ait Ali Abdelmounaim
Department of Surgery, First Medical and Surgical Center, Agadir, Morocco.
Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Visc Med. 2021 Mar;37(2):120-127. doi: 10.1159/000507380. Epub 2020 May 6.
Intussusception is a rare condition in adults. A pathological lesion is usually found with a significant percentage of malignancy. The optimal treatment is still not universally clear.
This is a retrospective review of adult patients with a diagnosis of intestinal intussusception and surgically treated at our institution from January 2009 to December 2018. Clinical, operative, and histological details were collected and analyzed.
A total of 26 cases, 16 males and 10 females, were diagnosed with surgically proven intussusception during the 10-year period. The mean age was 45 years (range 21-70). Using ultrasound and/or computed tomography as imaging study, the preoperative diagnosis was made in 21/26 (81%) patients. Five intussusceptions were discovered only upon exploratory laparotomy for intestinal obstruction. There were 19 (73%) cases of enteric and 7 (27%) cases of colonic intussusceptions. All patients underwent surgical exploration. Intestinal resection with immediate anastomosis was the technique of choice for most patients. A single patient underwent stoma for peritonitis secondary to intestinal perforation. An organic cause has been systematically revealed, and no idiopathic intussusception was detected. Etiology was malignant in 9 (35%) cases.
Adult intussusception should be considered in any patient with subacute abdominal pain. Considering the high rate of malignancy, intestinal resection without attempting reduction is highly recommended for colonic intussusceptions. However, a more selective approach can be adopted for enteric intussusceptions.
肠套叠在成人中是一种罕见疾病。通常会发现病理性病变，其中相当一部分为恶性。最佳治疗方法仍未完全明确。
这是一项对2009年1月至2018年12月在我院接受手术治疗的诊断为肠套叠的成年患者的回顾性研究。收集并分析了临床、手术及组织学细节。
在这10年期间，共26例患者被诊断为经手术证实的肠套叠，其中男性16例，女性10例。平均年龄为45岁（范围21 - 70岁）。使用超声和/或计算机断层扫描作为影像学检查，21/26（81%）的患者术前得以确诊。5例肠套叠仅在因肠梗阻行剖腹探查时才被发现。有19例（73%）为小肠肠套叠，7例（27%）为结肠肠套叠。所有患者均接受了手术探查。大多数患者的首选技术是肠切除并立即吻合。1例患者因肠穿孔继发腹膜炎而行造口术。系统性地揭示了一个器质性病因，未检测到特发性肠套叠。9例（35%）病因是恶性的。
任何出现亚急性腹痛的患者都应考虑成人肠套叠。鉴于恶性率高，对于结肠肠套叠，强烈建议不尝试复位而直接进行肠切除。然而，对于小肠肠套叠可采用更具选择性的方法。
