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老年患者腺癌诱发乙状结肠套叠及术后造口旁脏器脱出:一例报告及文献复习

Adenocarcinoma-Induced Sigmoid Colon Intussusception and Postoperative Parastomal Evisceration in an Elderly Patient: A Case Report and Literature Review.

作者信息

Alfaifi Jaber, Germain Adeline

机构信息

Department of General Surgery, King Khalid University, Abha, SAU.

Department of Hepatobiliary, Colorectal, and Digestive Surgery, University Hospital of Nancy, Nancy, FRA.

出版信息

Cureus. 2024 Feb 6;16(2):e53715. doi: 10.7759/cureus.53715. eCollection 2024 Feb.

DOI:10.7759/cureus.53715
PMID:38455783
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10919318/
Abstract

Intussusception in adults is less frequent than in children, and it is less commonly seen in the colon than in the intestines. This may be explained by the fixation of the colon to the retroperitoneum. We herein describe a case of sigmoid colon intussusception caused by a sigmoid colon adenocarcinoma. An 81-year-old man presented with abdominal pain and signs and symptoms of gastrointestinal obstruction. CT revealed a "target sign" with a mass in the sigmoid colon. We diagnosed the patient with colonic obstruction secondary to intussusception of the sigmoid colon and performed an emergency transverse colostomy. On the first postoperative day, the patient had a parastomal evisceration. Oncologic resection of the sigmoid colon without reduction of the intussusception was performed. The tumor was pathologically diagnosed as well-differentiated adenocarcinoma and classified as pT3N0. The patient was discharged on the ninth postoperative day with an uneventful postoperative course. The surveillance was validated for this patient.

摘要

成人肠套叠比儿童少见,且在结肠中比在小肠中更不常见。这可能是由于结肠与腹膜后固定有关。我们在此描述一例由乙状结肠癌引起的乙状结肠套叠病例。一名81岁男性因腹痛及胃肠道梗阻的体征和症状就诊。CT显示乙状结肠有一肿块的“靶征”。我们诊断该患者为乙状结肠套叠继发结肠梗阻,并进行了急诊横结肠造口术。术后第一天,患者出现造口旁脏器脱出。未复位肠套叠而行乙状结肠肿瘤切除。肿瘤经病理诊断为高分化腺癌,分类为pT3N0。患者术后第九天出院,术后过程顺利。对该患者进行了随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f2/10919318/bb727587fd21/cureus-0016-00000053715-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f2/10919318/0ec4932660a0/cureus-0016-00000053715-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f2/10919318/ac7aeeacfc4a/cureus-0016-00000053715-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f2/10919318/bb727587fd21/cureus-0016-00000053715-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f2/10919318/0ec4932660a0/cureus-0016-00000053715-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f2/10919318/ac7aeeacfc4a/cureus-0016-00000053715-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f2/10919318/bb727587fd21/cureus-0016-00000053715-i03.jpg

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本文引用的文献

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Laparoscopic Surgery for Adult Intussusception: Case Series.成人肠套叠的腹腔镜手术:病例系列。
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Early parastomal evisceration of small bowel following a loop ileostomy for malignant intestinal obstruction.恶性肠梗阻行袢式回肠造口术后早期小肠造口旁脏器脱出
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Parastomal Evisceration: A Report of Two Cases and Review of Literature.造口旁脏器脱出:两例报告及文献综述
Cureus. 2019 Sep 25;11(9):e5750. doi: 10.7759/cureus.5750.
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Influence of Ventilation Parameters on Intraabdominal Pressure.通气参数对腹内压的影响
J Crit Care Med (Targu Mures). 2016 May 9;2(2):80-84. doi: 10.1515/jccm-2016-0016. eCollection 2016 Apr.
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Factors predicting malignancy in adult intussusception: An experience in university-affiliated hospitals.成人肠套叠中恶性肿瘤的预测因素:大学附属医院的经验。
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Parastomal evisceration as an extremely rare complication of a common procedure.造口旁脏器脱出是一种常见手术极其罕见的并发症。
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Avoidance and management of stomal complications.造口并发症的预防与处理
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