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成人回肠息肉致肠套叠——病例报告

Adult intussusception due to ileal polyp - A case report.

作者信息

Hakim Tahmina

机构信息

Department: General Surgery, Campbelltown Hospital, 6 Quail Place, Ingleburn, NSW 2565, Australia.

出版信息

Int J Surg Case Rep. 2022 Oct;99:107554. doi: 10.1016/j.ijscr.2022.107554. Epub 2022 Aug 26.

Abstract

INTRODUCTION

Intussusception can be potential cause of bowel obstruction. Varying in clinical aetiologies, intestinal polyps are the most common cause where the possibilities of malignancy increase from proximal to distal colon. Laparoscopic reduction can be considered to prevent recurrence and complications of intussusception.

CASE PRESENTATION

A case report has been discussed where small bowel polyp caused intussusception which was diagnosed with Magnetic Resonance Enterography and managed with laparoscopy and bowel resection with anastomosis. 27 years old lady presented with colicky abdominal pain with no tenderness. Her initial CT abdomen showed ileo-ileal intussusception with possible soft tissue lesion. Her Magnetic Resonance Enterography (MRE) demonstrated tubular lipomatous polyp causing intussusception. She underwent elective diagnostic laparoscopy with bowel resection and anastomosis.

CLINICAL DISCUSSION

Intussusception is one of the common causes of intestinal obstruction which can be caused by intestinal polyp. With variable clinical features, intussusception can be diagnosed with CT scan. Laparoscopic procedure can be performed in case of symptomatic intestinal obstruction caused by intussusception.

CONCLUSION

CT abdomen can also be considered to diagnose intussusception where radiological feature of lead point can be diagnostic. Bowel resection is required in most of the cases to reduce complications of intussusception.

摘要

引言

肠套叠可能是肠梗阻的潜在病因。肠息肉的临床病因各异,是最常见的病因,从近端结肠到远端结肠,发生恶性肿瘤的可能性增加。可考虑进行腹腔镜复位以预防肠套叠的复发和并发症。

病例报告

讨论了一例小肠息肉导致肠套叠的病例,该病例通过磁共振小肠造影诊断,并通过腹腔镜手术及肠切除吻合术进行治疗。一名27岁女性因绞痛性腹痛就诊,无压痛。其最初的腹部CT显示回肠-回肠套叠,可能伴有软组织病变。她的磁共振小肠造影(MRE)显示管状脂肪瘤性息肉导致肠套叠。她接受了择期诊断性腹腔镜检查及肠切除吻合术。

临床讨论

肠套叠是肠梗阻的常见病因之一,可由肠息肉引起。肠套叠临床表现多样,CT扫描可用于诊断。对于由肠套叠引起的有症状肠梗阻,可进行腹腔镜手术。

结论

腹部CT也可用于诊断肠套叠,其中套叠点的影像学特征具有诊断价值。大多数情况下需要进行肠切除以减少肠套叠的并发症。

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