Kawaguchi Yuta, Maekawa Kyoichiro, Hashimoto Toshiaki, Kitagawa Mizuki, Urabe Shigetoshi, Yoshimura Emi, Goto Takashi, Rikitake Mihoko, Iwata Tohru
Department of Surgery, Japan Organization of Occupational Health and Safety, Nagasaki Rosai Hospital, Nagasaki, Japan.
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1- 7- 1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan.
Surg Case Rep. 2024 Nov 15;10(1):261. doi: 10.1186/s40792-024-02054-x.
Intussusception of the appendiceal endometriosis is rare. Although approximately 200 cases of appendiceal intussusception have been reported in the literature, very few have ever been diagnosed preoperatively. Here, we report the case of intussusception of the appendiceal endometriosis with laparoscopic ileocecal resection.
A woman in her 50s presented to the out-patients clinic with epigastric pain lasting for a several month. Contrast-enhanced computed tomography (CT) scanning revealed ileocolic intussusception in which a cecum polypoid mass lesion extended to the hepatic flexure of the ascending colon. A colonoscopy showed a large pedunculated polyp in the cecum. Laparoscopic ileocecal resection was performed. Pathology confirmed an invaginated appendix demonstrating endometriosis implants.
Possible intrinsic causes of intussusception are varied, appendiceal intussusception secondary to endometriosis is extremely rare. Intussusception of the appendix is a rare finding, often mistaken for a polyp. We suggest considering inverted appendix as a differential diagnosis when investigating cecal lesions.
阑尾子宫内膜异位症套叠罕见。尽管文献报道了约200例阑尾套叠病例,但术前确诊的却极少。在此,我们报告一例阑尾子宫内膜异位症套叠并行腹腔镜回盲部切除术的病例。
一名50多岁女性因上腹部疼痛持续数月就诊于门诊。增强计算机断层扫描(CT)显示回结肠套叠,盲肠息肉样肿块病变延伸至升结肠肝曲。结肠镜检查显示盲肠有一个大的带蒂息肉。行腹腔镜回盲部切除术。病理证实套叠的阑尾存在子宫内膜异位种植。
套叠的可能内在原因多种多样,子宫内膜异位继发的阑尾套叠极为罕见。阑尾套叠是一种罕见的发现,常被误诊为息肉。我们建议在研究盲肠病变时将倒位阑尾作为鉴别诊断考虑。