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一名年轻男性肠套叠的罕见病因及一种新的可能病因——病例报告

Rare cause of intussusception in a young male with a new possible etiology - A case report.

作者信息

Anand Arti, Nagpal Ashutosh, Arsia Ashish, Ahuja Arvind

机构信息

Lady Hardinge Medical College, New Delhi 110001, India.

Lady Hardinge Medical College, New Delhi 110001, India.

出版信息

Int J Surg Case Rep. 2023 May;106:108204. doi: 10.1016/j.ijscr.2023.108204. Epub 2023 Apr 19.

Abstract

INTRODUCTION

Inflammatory Fibroid Polyp (IFP) is a rare benign tumor of the gastrointestinal tract with no proven etiology. IFPs may sometimes produce complications like intussusception when present in the small bowel. This is a case report of a patient with an established diagnosis of inflammatory fibroid polyp with abdominal tuberculosis. Such co-existence has not been reported yet in literature.

CASE PRESENTATION

In this case report we see a 22-year-old gentleman presenting with a 10-day history of generalized abdominal pain which then progressed to obstipation. X-ray abdomen findings were consistent with small bowel obstruction. Computerized tomography imaging revealed the presence of a Jejuno-ileal intussusception. The patient was taken up for emergency laparotomy and he underwent resection of the intussuscepted segment with a polyp found as the lead point accompanied by dense bowel adhesions. Histopathological examination revealed it to be a Benign Fibro epithelial Polyp. Histopathology of the resected bowel segment and mesenteric lymph node also revealed findings confirmatory of abdominal tuberculosis. This may be a possible new etiology of the fibro epithelial polyp and this co-existence has never been reported before in literature.

CONCLUSION

Tuberculosis may be a possible inciting factor for the development of benign fibro epithelial polyp in the small bowel which may in turn lead to complications such as small bowel intussusception warranting need for surgical intervention.

摘要

引言

炎性纤维性息肉(IFP)是一种罕见的胃肠道良性肿瘤,病因尚不明确。IFP有时存在于小肠时可引发诸如肠套叠等并发症。本文报告一例确诊为炎性纤维性息肉合并腹部结核的患者。这种共存情况在文献中尚未见报道。

病例介绍

在本病例报告中,我们看到一名22岁男性,有10天的全腹疼痛病史,随后发展为便秘。腹部X线检查结果与小肠梗阻相符。计算机断层扫描成像显示存在空肠-回肠套叠。患者接受了急诊剖腹手术,切除了套叠段,发现息肉作为套叠头部,并伴有致密的肠粘连。组织病理学检查显示为良性纤维上皮性息肉。切除的肠段和肠系膜淋巴结的组织病理学检查也显示出腹部结核的确诊结果。这可能是纤维上皮性息肉的一种新病因,且这种共存情况在文献中此前从未有过报道。

结论

结核病可能是小肠良性纤维上皮性息肉发生的一个可能诱发因素,进而可能导致诸如小肠套叠等并发症,需要进行手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd4/10173147/a36e1dcb99ca/gr1.jpg

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