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酷似息肉的结肠内翻憩室:一例关于诊断挑战及临床意义的病例报告

Inverted colonic diverticulum mimicking a polyp: A case report on diagnostic challenges and clinical implications.

作者信息

Sholi Suha, Dawood Walla, Hajhamad Mohammed M H

机构信息

Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine; Department of General Surgery, An-Najah National University Hospital, Nablus 44839, Palestine.

Department of General Surgery, Rafidia Hospital, Nablus, Palestine.

出版信息

Int J Surg Case Rep. 2025 Jun;131:111389. doi: 10.1016/j.ijscr.2025.111389. Epub 2025 May 1.

Abstract

INTRODUCTION AND IMPORTANCE

Inverted colonic diverticulum (ICD) is a rare intraluminal lesion that typically presents with a polypoid appearance, which can make it challenging to differentiate from colonic polyps. ICDs occur in about 0.7 % to 1.7 % of individuals, with a mean age of 59 years, and a slightly higher prevalence in males.

CASE PRESENTATION

This case report presents a 40-year-old male with ICD that was misdiagnosed as polyp after a colonoscopy showed polypoid lesions in the context of diverticulosis and underwent polypectomy, colonoscopy completed. A few hours after the procedure, the patient developed symptoms consistent with complicated diverticulitis and required antibiotic treatment and CT-guided aspiration.

CLINICAL DISCUSSION

This case highlights the difficulty in differentiating ICD from colonic polyps during colonoscopy. Although ICDs are benign, they can closely resemble polyps, and misidentifying them may result in unnecessary and potentially harmful interventions. Endoscopists should be aware of the distinctive features of ICDs and employ techniques like probing and air insufflation to avoid unnecessary procedures.

CONCLUSION

Prompt recognition of ICDs can help prevent complications such as colonic perforation and unnecessary surgery, ultimately leading to improved patient outcomes.

摘要

引言与重要性

结肠内翻憩室(ICD)是一种罕见的腔内病变,通常表现为息肉样外观,这使得它与结肠息肉的鉴别具有挑战性。ICD在约0.7%至1.7%的个体中出现,平均年龄为59岁,男性患病率略高。

病例介绍

本病例报告介绍了一名40岁男性患有ICD,在结肠镜检查显示憩室病背景下有息肉样病变并进行息肉切除术后被误诊为息肉,结肠镜检查完成。术后数小时,患者出现与复杂性憩室炎一致的症状,需要抗生素治疗和CT引导下穿刺抽吸。

临床讨论

本病例突出了结肠镜检查期间将ICD与结肠息肉区分开来的困难。尽管ICD是良性的,但它们可能与息肉非常相似,误认它们可能导致不必要的且潜在有害的干预。内镜医师应了解ICD的独特特征,并采用探查和空气注入等技术以避免不必要的操作。

结论

及时识别ICD有助于预防诸如结肠穿孔和不必要手术等并发症,最终改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bb8/12147879/4c8d6a631178/gr1.jpg

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