Zangeneh Pouria, Fakhr Masoud Saadat, Rezvanfar Kiana, Gholami Poorya, Taghavi Tohid, Mohseni Maryam
Faculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
Department of Surgery, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Int J Surg Case Rep. 2024 Dec;125:110626. doi: 10.1016/j.ijscr.2024.110626. Epub 2024 Nov 16.
Intestinal intussusception is an uncommon condition in adults, particularly in young females, where one segment of the intestine telescopes into an adjacent segment, leading to bowel obstruction and potential compromise of blood supply. This case report presents a rare instance of intestinal intussusception in a 25-year-old female.
A 25-year-old female presented to the emergency department with severe, sudden-onset abdominal pain, nausea, and vomiting. Physical examination revealed a soft abdomen with tenderness and rebound tenderness initially in the right upper quadrant, which later migrated to the left upper quadrant, along with leukocytosis. Imaging studies, including X-ray, ultrasound, and contrast-enhanced computed tomography (CT) scan, demonstrated dilated intestinal loops, a "bowel within bowel" appearance suggestive of intussusception, and a right appendiceal cyst. The patient underwent surgical intervention after failing to respond to initial conservative management.
Adult intussusception is rare, often presenting with non-specific symptoms that can delay diagnosis and treatment. Imaging modalities, particularly CT scans, are crucial for accurate diagnosis, localizing the intussusception, identifying lead points, and guiding management. While conservative management may be considered for uncomplicated small bowel intussusceptions, surgical intervention is typically recommended for symptomatic cases, large bowel involvement, or suspected malignancy.
This case highlights the importance of maintaining a high index of suspicion for intussusception in adult patients presenting with abdominal symptoms, regardless of age or gender. Early recognition through appropriate imaging, such as contrast-enhanced computed tomography (CT), and prompt management, including timely surgical intervention when conservative treatment fails, is essential to optimize patient outcomes in this uncommon but potentially serious condition.
成人肠套叠是一种罕见病症,在年轻女性中尤为少见,即一段肠管套入相邻肠段,导致肠梗阻并可能影响血供。本病例报告呈现了一名25岁女性罕见的肠套叠病例。
一名25岁女性因突发剧烈腹痛、恶心和呕吐就诊于急诊科。体格检查发现腹部柔软,最初右上腹有压痛和反跳痛,随后转移至左上腹,伴有白细胞增多。包括X线、超声和增强计算机断层扫描(CT)在内的影像学检查显示肠袢扩张,呈“同心圆”外观提示肠套叠,以及右附件囊肿。患者在初始保守治疗无效后接受了手术干预。
成人肠套叠罕见,常表现为非特异性症状,可能延误诊断和治疗。影像学检查,尤其是CT扫描,对于准确诊断、确定肠套叠位置、识别引导点及指导治疗至关重要。对于单纯性小肠肠套叠可考虑保守治疗,但对于有症状的病例、大肠受累或怀疑有恶性肿瘤的情况,通常建议手术干预。
本病例强调了对于出现腹部症状的成年患者,无论年龄或性别,都要高度怀疑肠套叠的重要性。通过适当的影像学检查,如增强计算机断层扫描(CT)进行早期识别,并及时进行管理,包括在保守治疗失败时及时进行手术干预,对于在这种罕见但可能严重的疾病中优化患者预后至关重要。