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乙状结肠-直肠套叠由结肠癌引起。

Sigmoidorectal intussusception caused by colon carcinoma.

机构信息

Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.

School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.

出版信息

Acta Chir Belg. 2024 Dec;124(6):504-507. doi: 10.1080/00015458.2024.2384796. Epub 2024 Jul 29.

Abstract

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.

摘要

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。

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