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一名年轻成年人的阑尾套叠:囊性纤维化患者腹痛的重要鉴别诊断?

Intussusception of the appendix in a young adult: an important differential diagnosis of abdominal pain in cystic fibrosis patients?

作者信息

Venkatasami Meena, Cobby Ellen

机构信息

Department of Pathology, Royal Shrewsbury Hospital, Shrewsbury SY3 8XQ, UK.

出版信息

J Surg Case Rep. 2023 Mar 17;2023(3):rjad117. doi: 10.1093/jscr/rjad117. eCollection 2023 Mar.

DOI:10.1093/jscr/rjad117
PMID:36937795
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10023239/
Abstract

Cystic fibrosis (CF) is commonly associated with gastrointestinal manifestations from infancy to adulthood. Distal intestinal obstruction syndrome (DIOS) affects 20% of CF patients, where intussusception can be a rare complication. A 20-year-old CF male was diagnosed with a 3-day history of right iliac fossa pain and diarrhoea. Clinical examination revealed a tender palpable mass in the right iliac fossa and raised serum inflammatory markers. Contrast computerized-tomography of the abdomen-pelvis suggested intussusception of the appendix and further confirmed on histological analyses. The patient underwent an open appendicectomy where the intussusception had self-resolved. The literature review indicated a scarcity of data with 10 cases reported of intussusception in adult CF patients. Our case was in line with previous research of transient intussusception. This rare case highlights an importance to carry a higher index of suspicion for gastrointestinal manifestations in CF patients where differential diagnoses of DIOS and intussusception should be considered in the acute presentation.

摘要

囊性纤维化(CF)从婴儿期到成年期通常都伴有胃肠道表现。远端肠梗阻综合征(DIOS)影响20%的CF患者,其中肠套叠是一种罕见的并发症。一名20岁的CF男性被诊断为有3天的右下腹疼痛和腹泻病史。临床检查发现右下腹有压痛性可触及肿块,血清炎症标志物升高。腹部-盆腔对比计算机断层扫描提示阑尾肠套叠,组织学分析进一步证实。患者接受了开放性阑尾切除术,术中发现肠套叠已自行缓解。文献综述表明,关于成年CF患者肠套叠的数据稀缺,仅报道了10例。我们的病例与之前关于短暂性肠套叠的研究一致。这个罕见病例凸显了对CF患者胃肠道表现保持更高怀疑指数的重要性,在急性发病时应考虑DIOS和肠套叠的鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d91/10023239/68c2fab17124/rjad117f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d91/10023239/776dc6e43873/rjad117f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d91/10023239/68c2fab17124/rjad117f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d91/10023239/776dc6e43873/rjad117f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d91/10023239/68c2fab17124/rjad117f2.jpg

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引用本文的文献

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本文引用的文献

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Management and outcomes of paediatric ileocolic intussusception at a paediatric tertiary care hospital: A retrospective cohort study.一家儿科三级护理医院小儿回结肠套叠的管理与治疗结果:一项回顾性队列研究。
Paediatr Child Health. 2020 Nov 24;26(6):e252-e257. doi: 10.1093/pch/pxaa111. eCollection 2021 Oct.
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Transient Adult Jejunojejunal Intussusception: A Case of Conservative Management vs. Surgery.短暂性成人空肠空肠套叠:保守治疗与手术治疗的病例分析
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囊性纤维化中的远端肠梗阻综合征和结肠病变
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Intussusception in an adult with cystic fibrosis successfully reduced with contrast enema.一名患有囊性纤维化的成年人肠套叠通过造影灌肠成功复位。
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Intussusception of the appendix causing small bowel obstruction in a patient with cystic fibrosis.
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