Zong Beige, Xiao Xia, Deng Nijiao, Wang Wenjing, Peng Li, Fang Dianliang, Wang Haoyu, Hu Song, Li Zhongfu, Zhang Xin
Department of General Surgery, The Fourth People's Hospital of Chongqing, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.
Medical Imaging Department, The Fourth People's Hospital of Chongqing, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.
Front Med (Lausanne). 2024 Jan 5;10:1324792. doi: 10.3389/fmed.2023.1324792. eCollection 2023.
Intussusception refers to the invagination of a proximal loop of the bowel into an adjacent distal segment. This condition is rare in adults, especially when it involves a complete folding of the ileocecal area out of the body cavity. Meanwhile, enterogenous cysts are congenital malformations that are largely identified in childhood following symptoms of bowel obstruction. While surgical treatment is ultimately required for both diseases, deciding on the type of surgery and the right time to operate can be a challenge for clinicians. It is especially difficult to decide on treatment for an adult with the coincidental occurrence of both conditions and no definitive pathologic diagnosis prior to surgery. Here, we present the case study of a 19-year-old female patient who presented with a prolapsed anus due to intussusception caused by a large ileocecal mass. The patient was admitted to the emergency department with a "massive anal mass." She remained symptomatic after receiving conventional conservative treatment and had to undergo emergency surgery after developing an intestinal obstruction. While the patient's intraoperative condition also confirmed the preoperative CT findings, the situation became more complicated during surgery. The postoperative pathological report indicated the presence of an enterogenous cyst. After recovery from surgery, the patient was successfully discharged. Intussusception or intestinal obstruction caused by an intestinal mass is a surgical indication, and removal is the only way to cure the condition. This case study provides a helpful reference for general surgeons, especially anorectal surgeons, imaging physicians, and pathologists, and informs the diagnosis and treatment of this patient population.
肠套叠是指一段肠管近端套入相邻的远端肠段。这种情况在成人中很少见，尤其是当它涉及到回盲部完全折叠出体腔时。同时，肠源性囊肿是先天性畸形，大多在儿童期出现肠梗阻症状后被发现。虽然这两种疾病最终都需要手术治疗，但对于临床医生来说，决定手术类型和合适的手术时机可能是一项挑战。对于同时出现这两种情况且术前没有明确病理诊断的成年患者，决定治疗方案尤其困难。在此，我们报告一例19岁女性患者的病例研究，该患者因巨大回盲部肿物导致肠套叠而出现肛门脱垂。患者因“巨大肛门肿物”入住急诊科。接受传统保守治疗后仍有症状，出现肠梗阻后不得不接受急诊手术。虽然患者的术中情况也证实了术前CT检查结果，但手术过程中情况变得更加复杂。术后病理报告显示存在肠源性囊肿。手术后康复后，患者顺利出院。由肠道肿物引起的肠套叠或肠梗阻是手术指征，切除是治愈该病的唯一方法。本病例研究为普通外科医生，尤其是肛肠外科医生、影像科医生和病理科医生提供了有益的参考，并为该患者群体的诊断和治疗提供了依据。
