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成人肠套叠:来自单一机构的回顾性研究

Intussusception in Adults: A Retrospective Review from a Single Institution.

作者信息

Kim Ki Hoon

机构信息

Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.

出版信息

Open Access Emerg Med. 2021 Jun 14;13:233-237. doi: 10.2147/OAEM.S313307. eCollection 2021.

Abstract

PURPOSE

Intussusception is uncommon in adults and often manifests as nonspecific symptoms. Owing to its low incidence and the lack of knowledge on the symptoms, causes, and treatment of adult intussusception (AI), many surgeons may have limited experience in the diagnosis and treatment of intussusception. This study aimed to describe the experience of AI and discuss its clinical presentation, etiology, and management.

MATERIAL AND METHODS

I retrospectively reviewed patients aged 19 years and older who were diagnosed with intussusception at a single institution between March 2010 and December 2019.

RESULTS

Among 28 patients who were finally analyzed, abdominal pain was the most commonly observed symptom. Ileocolic and ileoileal intussusceptions were the most common locations, and a lead point was observed in 19 cases (68%), of which malignancy was observed in six (21%). Bowel resection was performed in 27 cases. According to the pathological findings of the tissue from the resected section, nine and three cases of small bowel intussusception (SBI) were benign and malignant, respectively, whereas 13 and three cases of colonic intussusception (CI) were benign and malignant, respectively. On comparing SBI and CI, it was observed that most variables did not significantly differ, except for the duration of symptoms.

CONCLUSION

SBI had a higher lead point than CI. The rate of malignancy in CI cases in this study was lower than that reported in other studies. En-bloc resection can be considered the first option for the treatment of AI.

摘要

目的

肠套叠在成人中并不常见,且常表现为非特异性症状。由于成人肠套叠(AI)的发病率低,以及对其症状、病因和治疗缺乏了解,许多外科医生在肠套叠的诊断和治疗方面可能经验有限。本研究旨在描述AI的诊治经验,并探讨其临床表现、病因及处理方法。

材料与方法

我回顾性分析了2010年3月至2019年12月期间在一家机构被诊断为肠套叠的19岁及以上患者。

结果

在最终分析的28例患者中,腹痛是最常见的症状。回结肠型和回肠型肠套叠是最常见的部位,19例(68%)观察到有一个引导点,其中6例(21%)为恶性肿瘤。27例患者接受了肠切除术。根据切除段组织的病理结果,小肠套叠(SBI)中9例为良性,3例为恶性,而结肠套叠(CI)中13例为良性,3例为恶性。比较SBI和CI时发现,除症状持续时间外,大多数变量无显著差异。

结论

SBI的引导点比CI更多。本研究中CI病例的恶性肿瘤发生率低于其他研究报道。整块切除可被视为AI治疗的首选方案。

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