Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.
Acta Chir Belg. 2024 Dec;124(6):504-507. doi: 10.1080/00015458.2024.2384796. Epub 2024 Jul 29.
Intussusception, the invagination of a bowel segment into an adjacent segment, occurs in 5% of adult patients with an obstruction of the bowel. It is often seen as a result of obstructive defecation syndrome or malignancy. However, a sigmoidal malignancy as lead point is rare. Symptoms in adults are less specific than in children, which makes preoperative diagnosis challenging. An 85-year-old female presented with bright red anal blood loss. A large palpable mass was found during rectal examination. A computed tomography was performed during workup, which showed a 'target-sign' on the location of the lesion. An intussusception of the sigmoid into the rectum was seen over the length of 15 cm. This particular type of intussusception is extremely rare. When a neoplasm is suspected to be the lead point, an oncological resection is recommended. We performed a total mesorectal excision, after which the patient had an uneventful recovery.
肠套叠是指肠段的一部分嵌入到相邻的肠段中,在 5%的肠梗阻成年患者中发生。它通常是由于阻塞性排便综合征或恶性肿瘤引起的。然而,乙状结肠恶性肿瘤作为套叠的起点是罕见的。成人的症状不如儿童特异性,这使得术前诊断具有挑战性。一位 85 岁的女性因鲜红色肛门出血就诊。直肠检查时发现一个可触及的大肿块。在检查过程中进行了计算机断层扫描,显示病变部位呈“靶征”。可见乙状结肠长达 15 厘米的肠套叠进入直肠。这种特殊类型的肠套叠非常罕见。当怀疑肿瘤是套叠的起点时,建议进行肿瘤切除。我们进行了全直肠系膜切除术,之后患者恢复顺利。