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婴儿小肠血管瘤致肠套叠的管理:1例罕见病例报告及文献复习

Management of a small bowel hemangioma causing intussusception in an infant: A rare case report and literature review.

作者信息

Helal Imen, Hasnaoui Anis, Daïb Aida, Jouini Raja, Khanchel Fatma, Chadli Debbiche Ashraf

机构信息

Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar, 1006 Tunis, Tunisia; Department of Pathology, Habib Thameur Hospital, Tunisia.

Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar, 1006 Tunis, Tunisia.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110108. doi: 10.1016/j.ijscr.2024.110108. Epub 2024 Jul 31.

Abstract

INTRODUCTION

Hemangiomas of the small intestine are rare and usually present in young people. They are very difficult to diagnose preoperatively. We report a rare case of mixed intestinal hemangioma (IH) causing intussusception in a pediatric patient.

CASE PRESENTATION

A 3-month-old girl, with no prior medical or surgical history, was admitted with rectal bleeding and paroxysmal crying due to intermittent abdominal pain. An urgent abdominal ultrasound revealed ileo-ileal intussusception. Operative findings confirmed the intussusception, and a segmental resection of the intussuscepted jejunum was performed. Histopathological examination found a mixed hemangioma. The postoperative course was uneventful.

DISCUSSION

Clinical presentation may include intestinal bleeding leading to anemia, obstruction, intussusception and perforation. Intussusception caused by small bowel hemangioma is extremely rare. Notably, we didn't find any cases of small bowel hemangioma revealed by intussusception in children. The main treatment for hemangiomas is surgical resection of the affected segment. No evidence in the literature on postoperative recurrence of hemangiomas.

CONCLUSION

Intussusception secondary to intestinal hemangiomas is extremely rare. Preoperative diagnosis is challenging as they are often undetectable with traditional techniques. Enhanced awareness and understanding of this condition can facilitate earlier diagnosis and improve management outcomes.

摘要

引言

小肠血管瘤罕见,通常见于年轻人。术前很难诊断。我们报告一例小儿患者因混合性肠血管瘤导致肠套叠的罕见病例。

病例介绍

一名3个月大的女孩,既往无内科或外科病史,因间歇性腹痛伴直肠出血和阵发性哭闹入院。紧急腹部超声显示回肠-回肠型肠套叠。手术所见证实为肠套叠,遂对套叠的空肠进行节段性切除。组织病理学检查发现为混合性血管瘤。术后过程顺利。

讨论

临床表现可能包括导致贫血的肠道出血、梗阻、肠套叠和穿孔。小肠血管瘤引起的肠套叠极为罕见。值得注意的是,我们未发现儿童肠套叠提示小肠血管瘤的任何病例。血管瘤的主要治疗方法是手术切除受累节段。文献中没有关于血管瘤术后复发的证据。

结论

肠血管瘤继发肠套叠极为罕见。术前诊断具有挑战性,因为传统技术往往无法检测到。提高对这种情况的认识和理解有助于早期诊断并改善治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e692/11359742/376fdbe6d8d9/gr1.jpg

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