Aregawi Alazar Berhe, Girma Abdulkerim
Department of Surgery, Hawassa University Comprehensive Specialized Hospital, Hawassa University, Hawassa, Sidama, Ethiopia.
Department of Radiology, Yanet Internal Medicine Specialized Centre, Hawassa, Sidama, Ethiopia.
Int Med Case Rep J. 2023 Jan 28;16:65-72. doi: 10.2147/IMCRJ.S398426. eCollection 2023.
Intussusception is primarily a disease of children and is the primary cause of intestinal obstruction in the pediatric age group. It accounts for around 5-16% of cases of intestinal obstruction in adults of the western population. Most cases of adult intussusception (up to 90%) are secondary to an identified structural lesion or a lead point contrary to pediatric intussusception. Adults with intussusception present with subacute or chronic symptoms of partial obstruction. CT is the best imaging to make a preoperative diagnosis of adult intussusception. The standard treatment for adult intussusception is surgery, and non-operative reduction should not be attempted. Here, we present a rare case of idiopathic small bowel intussusception in a 50-year-old woman. She presented with crampy abdominal pain for one-week duration. It was associated with frequent vomiting of bilious matter. She claimed to have had similar symptoms for the past 2 months and had repeatedly visited nearby health facilities. She had an abdominal CT, which suggested a complicated small bowel intussusception. Exploratory laparotomy was done, and there was a small bowel intussusception and an inflammatory stricture at the end of the intussusceptum, which is believed to form a closed-loop like obstruction. The intussusceptum was resected en-bloc then end-to-end jejuno-jejunal anastomosis was performed. This case report makes physicians aware of this rare condition in adults. So that they have a high index of suspicion when a patient presents with symptoms of subacute or chronic intestinal obstruction and inform that abdominal CT should be done in these circumstances and surgery is the mainstay of treatment. Our case is unique, and there is no report in the literature similar to ours.
肠套叠主要是一种儿童疾病，是小儿年龄段肠梗阻的主要原因。在西方人群的成人肠梗阻病例中，它占5%-16%左右。与小儿肠套叠不同，大多数成人肠套叠病例（高达90%）继发于已确定的结构性病变或引导点。患有肠套叠的成人表现为部分梗阻的亚急性或慢性症状。CT是术前诊断成人肠套叠的最佳影像学检查。成人肠套叠的标准治疗方法是手术，不应尝试非手术复位。在此，我们报告一例50岁女性特发性小肠套叠的罕见病例。她出现痉挛性腹痛持续一周。伴有频繁呕吐胆汁样物质。她声称在过去2个月有类似症状，并多次前往附近医疗机构就诊。她进行了腹部CT检查，提示复杂性小肠套叠。进行了剖腹探查术，发现有小肠套叠，套入部末端有炎性狭窄，据信形成了类似闭环的梗阻。将套入部整块切除，然后进行空肠-空肠端端吻合术。本病例报告使医生了解成人中的这种罕见情况。以便当患者出现亚急性或慢性肠梗阻症状时，他们有较高的怀疑指数，并告知在这些情况下应进行腹部CT检查，手术是主要治疗方法。我们的病例很独特，文献中没有与我们类似的报道。
