Gastroenterology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.
Eur Rev Med Pharmacol Sci. 2022 Jan;26(2):350-353. doi: 10.26355/eurrev_202201_27859.
Intussusception is a common condition of bowel obstruction in pediatric patients. However, 5% of all cases occur in adults, mostly aged over fifty, with no difference based on sex, representing about 1% of all causes of bowel obstruction. Compared to pediatric population, it is triggered by a pathologic lead point in about 85% of cases, represented in 60% of cases by malignant and benign neoplasms. Among these neoplasms, an inflammatory fibroid polyp (IFP), a benign neoplastic submucosal lesion also known as Vanek's tumor, is considered a very uncommon cause of adult intussusception. Clinical presentation could differ by location and size of tumor, and may include abdominal pain, nausea, vomiting, diarrhea or constipation, bleeding, weight loss, palpable abdominal mass, bowel obstruction, and gastrointestinal bleeding. Considering its common and non-specific symptoms, radiologic imaging plays a key role in the diagnosis of an IFP, especially computed tomography (CT) scan, which represents the most sensitive modality to confirm intussusception. However, bowel sonography (BS) has become an accurate procedure in various pathological intestinal diseases, also including intussusception. In this paper, we report a rare case of ileo-ileal intussusception secondary to Vanek's tumor diagnosed by BS.
肠套叠是小儿肠梗阻的常见原因。然而,5%的病例发生在成年人,大多数年龄在五十岁以上,无论性别如何,其发病率均无差异,占肠梗阻所有病因的 1%左右。与儿科人群相比,约 85%的病例由病理性的引发点引起,其中 60%由恶性和良性肿瘤引起。在这些肿瘤中,炎性纤维瘤息肉(IFP),一种良性黏膜下肿瘤,也称为 Vanek 瘤,被认为是成人肠套叠非常罕见的原因。临床表现可能因肿瘤的位置和大小而异,可能包括腹痛、恶心、呕吐、腹泻或便秘、出血、体重减轻、可触及的腹部肿块、肠梗阻和胃肠道出血。鉴于其常见且无特异性的症状,影像学检查在 IFP 的诊断中起着关键作用,特别是计算机断层扫描(CT),它是确认肠套叠最敏感的方式。然而,肠超声(BS)在各种肠道疾病的诊断中,包括肠套叠,已经成为一种准确的方法。本文报告了一例由 Vanek 瘤引起的罕见回肠-回肠型肠套叠的病例,该病例通过 BS 进行诊断。