Zhao Guowei, Meng Wenjun, Bai Lian, Li Qigang
Department of Gastrointestinal Surgery, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2022 Sep 9;9:984853. doi: 10.3389/fsurg.2022.984853. eCollection 2022.
Adults with bowel intussusception caused by malignant tumors are fairly uncommon. We presented a case of a 64-year-old woman whose intussusception was secondary to ascending colon cancer. A color Doppler ultrasonography of the abdomen revealed a low echo mass in the right middle abdomen. Physical examination and digital rectal examination were both unremarkable. Computed tomography (CT) revealed a concentric circle change in the colon, as well as the mesenterium and arteries. Electronic colonoscopy discovered the colonic giant proliferative lesions and stenosis. Adenocarcinoma with moderate differentiation was discovered after a biopsy. Then laparotomy showed intussusception and the tumor was located in the ascending colon. The postoperative pathological test revealed moderately differentiated adenocarcinoma in the right colon invaded the whole layer. After hospitalization, the patient was discharged without any complications. This case highlights that rational use of CT, endoscopy, and timely surgery combines an effective strategy for the treatment of adult intussusception.
由恶性肿瘤引起的成人肠套叠相当少见。我们报告了一例64岁女性患者,其肠套叠继发于升结肠癌。腹部彩色多普勒超声检查显示右中腹部有一个低回声肿块。体格检查和直肠指检均无异常。计算机断层扫描(CT)显示结肠、肠系膜和动脉呈同心圆改变。电子结肠镜检查发现结肠巨大增生性病变和狭窄。活检后发现中度分化腺癌。然后剖腹探查显示肠套叠,肿瘤位于升结肠。术后病理检查显示右半结肠中度分化腺癌侵犯全层。住院后,患者无任何并发症出院。该病例强调合理使用CT、内镜检查以及及时手术是治疗成人肠套叠的有效策略。