Greer Douglas, Fernandez Adrian
Department of Surgery, South East Regional Hospital, Bega, NSW, Australia.
Ann Coloproctol. 2024 May;40(Suppl 1):S15-S17. doi: 10.3393/ac.2021.00724.0103. Epub 2021 Nov 18.
Intussusception involving the colon is unusual in adults and when present is managed with resection due to the risk of malignancy. We present an unusual case where the intussusceptum was impacted stool in a mucosal pouch in the transverse colon. The patient presented with bleeding per rectum and abdominal pain and was found to have a colocolic intussusception on computed tomography. Colonoscopy showed an ulcerated mass in the transverse colon. A laparoscopic right hemicolectomy was performed. Histopathology demonstrated known chronic lymphocytic leukemia, but not solid malignancy. A large fecalith impacted within a mucosal pouch had acted as the lead point. This represents a highly unusual but benign cause of intussusception.
成人结肠套叠并不常见,一旦出现,由于存在恶变风险,通常采用切除术治疗。我们报告了一例罕见病例,套入部为横结肠黏膜袋内的嵌塞粪便。患者出现便血和腹痛,计算机断层扫描发现为结肠结肠套叠。结肠镜检查显示横结肠有一个溃疡肿物。遂行腹腔镜右半结肠切除术。组织病理学显示为已知的慢性淋巴细胞白血病,但未发现实体恶性肿瘤。一个嵌塞在黏膜袋内的大粪石充当了套叠的起始点。这是一种极为罕见但良性的套叠病因。