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反复出现的右上腹疼痛掩盖了潜在的结肠腺癌诱发的肠套叠。

Recurrent Right Upper Quadrant Pain Masquerading an Underlying Colon Adenocarcinoma-Induced Intussusception.

作者信息

Qiryaqoz Zeena Ayad, Katiyar Urvashi, Shebrain Saad

机构信息

Western Michigan University Homer Stryker, School of Medicine, Kalamazoo, Michigan, USA.

Bronson Methodist Hospital, Kalamazoo, Michigan, USA.

出版信息

Case Rep Gastroenterol. 2021 Jun 10;15(2):501-506. doi: 10.1159/000516863. eCollection 2021 May-Aug.

Abstract

Intussusception in adults is a challenging diagnosis that often requires a high degree of suspicion. In adults presenting with symptoms, almost 90% have underlying neoplasms. Most frequently, the presentation will include nonspecific abdominal pain, vomiting, and mucoid hematochezia. In this case, we present a 39-year-old female with a rare presentation of chronic, recurrent right upper quadrant abdominal pain over a 5-month interval. The misleading presentation with which the patient presented led to a delay in diagnosis and treatment of colon malignancy and serves to advocate for intussusception as a differential for adult patients presenting with obstructive symptoms of unknown origin and recurrent abdominal pain. Such cases should persuade physicians to plan prompt surgical intervention as to not delay optimal diagnostic and therapeutic outcomes.

摘要

成人肠套叠是一种具有挑战性的诊断,通常需要高度怀疑。在出现症状的成人中,近90%有潜在的肿瘤。最常见的表现包括非特异性腹痛、呕吐和黏液血便。在此病例中,我们报告一名39岁女性,其罕见地在5个月内反复出现慢性右上腹腹痛。患者出现的误导性表现导致结肠恶性肿瘤的诊断和治疗延迟,这也促使我们将肠套叠作为成年患者不明原因梗阻症状和反复腹痛的鉴别诊断。此类病例应促使医生计划及时进行手术干预,以免延误最佳诊断和治疗结果。

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