Hadid Tarik, Elazzamy Haidy, Kafri Zyad
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
Department of Internal Medicine, Ascension St. John Hospital, Detroit, Michigan, USA.
Case Rep Gastroenterol. 2020 Jan 20;14(1):27-33. doi: 10.1159/000505511. eCollection 2020 Jan-Apr.
Intussusception is a rare phenomenon in adults and usually presents with bowel obstruction. Unlike child intussusception, adult intussusception is seldom idiopathic and frequently associated with secondary causes such as benign and malignant tumors. While most cases are treated surgically, emerging data suggest a more conservative management approach for patients with short-segment adult intussusception and without high-risk features such as bowel obstruction, mass seen on imaging, colon involvement, or constitutional symptoms of malignancy. We present a rare case of adult intussusception due to unsuspected adenocarcinoma of the jejunum, treated successfully with surgical resection followed by adjuvant chemotherapy. We favor the surgical rather than conservative approach for adult patients with intussusception to avoid missing unsuspected malignant tumors that are not readily visualized on imaging studies.
肠套叠在成人中是一种罕见现象，通常表现为肠梗阻。与儿童肠套叠不同，成人肠套叠很少是特发性的，且常与良性和恶性肿瘤等继发原因相关。虽然大多数病例采用手术治疗，但新出现的数据表明，对于短节段成人肠套叠且无肠梗阻、影像学检查发现肿块、结肠受累或恶性肿瘤全身症状等高风险特征的患者，可采用更保守的管理方法。我们报告了一例罕见的因空肠意外腺癌导致的成人肠套叠病例，通过手术切除并辅助化疗成功治疗。对于患有肠套叠的成年患者，我们倾向于采用手术而非保守方法，以避免漏诊在影像学检查中不易发现的意外恶性肿瘤。
