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中年男性黏液腺癌导致的回结肠套叠:一种罕见表现。

Ileocolic Intussusception Due to Mucinous Adenocarcinoma in a Middle-Aged Man: A Rare Presentation.

作者信息

Johari Ananya, Ahmad Samir, Selvaraj Karthikeyan, Arunachalam Ganesh Ramki

机构信息

General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.

出版信息

Cureus. 2025 Jan 28;17(1):e78136. doi: 10.7759/cureus.78136. eCollection 2025 Jan.

Abstract

The invagination, or telescoping, of one segment of the colon into another distal segment is the hallmark of the medical disorder known as intussusception. The invaginated portion of the intestines may be propelled forward by peristaltic movements, which may result in bowel blockage, ischemia, and long-term necrosis. The precise cause of intussusception is ambiguous, particularly in cases with no clear lead point. Dysrhythmic contractions and lymphoid hyperplasia are nevertheless linked to the pathophysiology. A 54-year-old male patient arrived at our emergency department after experiencing abdominal pain that had been progressively increasing for the past three days. The patient had a history of previous appendectomy. It was reported that the pain was abrupt and severe and that it grew worse with each meal or drink. During the physical examination, abdominal distension, discomfort, central guarding, and a small palpable mass measuring 3 x 3 cm were identified. Contrast-enhanced CT scans revealed a 7 cm segment intussusception of the terminal ileum into the cecum and ascending colon. Furthermore, the cecum, mesentery, vasculature, and subsequent nodes were all involved in a significant amount of wall edema. During an emergency laparotomy, a terminal ileocolic intussusception was identified. A restricted segmental resection of the terminal ileum was conducted after the adhesiolysis. Subsequently, an end ileostomy was performed. Ileocolic obstructive intussusception is a rare adult condition caused by a mucinous adenocarcinoma. This case provides a unique perspective on the condition. Consequently, physicians must be vigilant for indications of obstructive intussusception in various colon regions that may suggest malignancy.

摘要

结肠的一段套入另一段远侧结肠,即肠套叠,是一种医学病症的标志。套入的肠段可能会因蠕动而向前推进,这可能导致肠梗阻、缺血和长期坏死。肠套叠的确切病因尚不明确,尤其是在没有明确引导点的情况下。然而,节律异常的收缩和淋巴组织增生与病理生理学有关。一名54岁男性患者在经历了过去三天逐渐加重的腹痛后抵达我们的急诊科。该患者有阑尾切除术史。据报告,疼痛突然且剧烈,每次进食或饮水后都会加重。体格检查时,发现腹部膨隆、不适、腹部中央压痛,可触及一个3×3厘米的小肿块。增强CT扫描显示末端回肠7厘米段套入盲肠和升结肠。此外,盲肠、肠系膜、血管系统以及随后的淋巴结均有大量壁水肿。在急诊剖腹手术中,发现了末端回结肠套叠。粘连松解后,对末端回肠进行了局限性节段性切除。随后,进行了末端回肠造口术。回结肠梗阻性套叠是一种由黏液腺癌引起的罕见成人疾病。该病例为这种疾病提供了独特的视角。因此,医生必须警惕各个结肠区域可能提示恶性肿瘤的梗阻性套叠迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bde4/11867215/069a01911a2a/cureus-0017-00000078136-i01.jpg

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