Department of General Surgery, Military Hospital, Khartoum, Sudan.
J Med Case Rep. 2023 Jul 14;17(1):299. doi: 10.1186/s13256-023-04027-4.
Adult Intussusception is an uncommon diagnosis, with one to three cases occurring in a population of 1,000,000 per year, primarily due to underlying pathological lead points, of which 70% are malignant. Lipoma is the most common benign tumour, and primary adenocarcinoma is the most common malignant one. Early diagnosis and treatment are essential to reducing poor outcomes, including ischemia, perforation, and sepsis. Computed tomography imaging is a modality of choice for diagnosis. With a diagnostic accuracy of up to 100% and a specificity of up to 71%. Surgical intervention is the definitive treatment, and the decision is taken according to the situation.
A 61-year-old Black African female presented to our surgical casualty with intermittent colicky abdominal pain for 1 month. After that, she started to experience abdominal swelling in the right iliac fossa. A CT scan confirmed the presence of colo-colic Intussusception, cecum-ascending-transverse colon. Laparotomy was scheduled, and a right hemicolectomy was done accordingly. Diagnosis of adenocarcinoma (Dukes stage B2) was made histologically.
Intussusception in adults is a challenging diagnosis requiring high clinical suspicion and has a high incidence of fatal complications. Colonic cancer can be worsening by any infection and chronic medical problem. CT imaging is the lifesaving modality of choice for diagnosis. Good patient outcomes depend on timely diagnosis and recruitment of a multi-disciplinary team.
成人肠套叠是一种罕见的诊断，每 100 万人中约有 1 至 3 例，主要是由于潜在的病理性引发点，其中 70%为恶性。脂肪瘤是最常见的良性肿瘤，而原发性腺癌是最常见的恶性肿瘤。早期诊断和治疗对于降低不良预后至关重要，包括缺血、穿孔和败血症。计算机断层扫描成像（CT 成像）是诊断的首选方法，其诊断准确率高达 100%，特异性高达 71%。手术干预是明确的治疗方法，具体决策取决于病情。
一名 61 岁的黑人女性因间歇性绞痛性腹痛 1 个月，随后开始出现右髂窝腹部肿胀，到我院外科急诊就诊。CT 扫描证实存在结肠-结肠套叠，盲肠-升结肠-横结肠。随后安排了剖腹手术，并进行了右半结肠切除术。组织学诊断为腺癌（ Dukes 分期 B2 期）。
成人肠套叠的诊断具有挑战性，需要高度的临床怀疑，并且有很高的致命并发症发生率。任何感染和慢性医疗问题都可能使结肠癌恶化。CT 成像诊断是挽救生命的首选方法。良好的患者预后取决于及时诊断和多学科团队的组建。
