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成人特发性小肠套叠:保守治疗与手术治疗对比

Idiopathic Small Bowel Intussusception in Adults: Conservative Versus Surgical Management.

作者信息

Pindek Rachel, Shamsian Ethan, Mcdonald Molly, Wilson Abralena, Louie Kevin

机构信息

Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA.

Surgery, Mount Sinai South Nassau, Oceanside, USA.

出版信息

Cureus. 2023 Sep 18;15(9):e45460. doi: 10.7759/cureus.45460. eCollection 2023 Sep.

Abstract

Intussusception is a rare diagnosis in adults and generally has a pathological cause. In this case report, we highlight an adult, male patient who presented with typical signs and symptoms of intussusception, and a diagnosis was subsequently confirmed with imaging. After 24 hours of no clinical improvement, the intussusception was resolved through a laparoscopic approach. No lead point or other pathological cause was identified that may have contributed to the development of intussusception. The idiopathic presentation of intussusception in adults is scarcely represented in the scientific literature, making its best management practices vague and leaving room for studies regarding best surgical management. We conducted a brief literature review of adult idiopathic intussusception cases and found fewer than 25 cases documented since 2010. Our analysis revealed that the majority of cases were resolved through a laparoscopic method and only about a quarter were conservatively managed with supportive measures. More research is needed in this subject matter to more accurately determine the need for surgical management in cases of adult idiopathic intussusception.

摘要

肠套叠在成人中是一种罕见的诊断,通常有病理原因。在本病例报告中,我们重点介绍了一名成年男性患者,他表现出肠套叠的典型体征和症状,随后经影像学检查确诊。在24小时临床症状无改善后,通过腹腔镜手术解决了肠套叠问题。未发现可能导致肠套叠发生的引导点或其他病理原因。成人特发性肠套叠的表现鲜有在科学文献中报道,这使得其最佳管理方法不明确,也为关于最佳手术管理的研究留下了空间。我们对成人特发性肠套叠病例进行了简要的文献回顾,发现自2010年以来记录在案的病例不到25例。我们的分析表明,大多数病例通过腹腔镜方法得到解决,只有约四分之一的病例采用支持性措施进行保守治疗。在这个主题上需要更多的研究,以便更准确地确定成人特发性肠套叠病例的手术管理需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad27/10583731/9d9defd3a488/cureus-0015-00000045460-i01.jpg

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