Salam Ammara, Chkir Baraa, Haq Shua, Mansour Moustafa
Manchester University NHS Foundation Trust, Manchester, UK
Manchester University NHS Foundation Trust, Manchester, UK.
BMJ Case Rep. 2025 Mar 7;18(3):e263469. doi: 10.1136/bcr-2024-263469.
We report the case of a woman in her early 60s, who presented with colocolic intussusception, leading to acute large bowel obstruction. The patient presented with colicky abdominal pain, diarrhoea mixed with blood and mucous and raised inflammatory markers. Abdominal examination revealed mild tenderness in the left lower abdomen. The CT scan reported colocolic intussusception extending from proximal to mid-sigmoid colon, with early ischaemic changes. The patient underwent laparoscopy-assisted sigmoid colectomy with an end colostomy and an uneventful postoperative recovery. Histopathological examination identified a benign colonic lipoma, with ischaemic and necrosed intussuscepted colonic segment. Intestinal intussusception is rare in adults and only accounts for 1% of the cases of intestinal obstruction in adults, mostly caused by a pathological lead point like colonic adenocarcinoma or a benign lipoma. Due to the potential risk of malignancy, radiological decompression is not advisable in adults, and en bloc resection of the intussuscepted segment is recommended.
我们报告了一名60岁出头女性的病例，她因结肠结肠套叠导致急性大肠梗阻。患者表现为绞痛性腹痛、便血和黏液便以及炎症标志物升高。腹部检查发现左下腹轻度压痛。CT扫描显示结肠结肠套叠从乙状结肠近端延伸至中段，伴有早期缺血改变。患者接受了腹腔镜辅助乙状结肠切除术并进行了末端结肠造口术，术后恢复顺利。组织病理学检查发现一个良性结肠脂肪瘤，套叠的结肠段有缺血和坏死。成人肠套叠罕见，仅占成人肠梗阻病例的1%，主要由结肠腺癌或良性脂肪瘤等病理性引导点引起。由于存在恶性肿瘤的潜在风险，成人不建议进行放射学减压，建议整块切除套叠段。
