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成人炎症性假瘤继发双回肠套叠:一例罕见病例报告

Double ileo-ileal intussusception secondary to inflammatory pseudotumor in an adult: A rare case report.

作者信息

Satpathy Sarthak, Pattanayak Sibaprashad, Sahoo Jitendra Kumar, Patnaik Satyaswarup, Behera Umesh Chandra, Samantaray Chinmay

机构信息

Department of General Surgery, MKCG Medical College and Hospital, Berhampur, Odisha, India.

Department of General Surgery, MKCG Medical College and Hospital, Berhampur, Odisha, India.

出版信息

Int J Surg Case Rep. 2025 Jul;132:111500. doi: 10.1016/j.ijscr.2025.111500. Epub 2025 Jun 11.

Abstract

INTRODUCTION

Adult intussusception is rare and typically associated with an underlying lead point. Inflammatory pseudotumor, a rare benign lesion of uncertain etiology, can serve as such a lead point in the small bowel. The occurrence of double intussusception in this context is exceptionally uncommon.

PRESENTATION OF CASE

A 55-year-old woman presented with signs of small bowel obstruction. Imaging(Fig. 1-11) revealed ileo-ileal intussusception. Intraoperatively(Fig. 16-18), a Double intussusception configuration was observed where one intussuscepted segment acted as the lead point for a second. A firm lesion at the apex was resected. Histopathology confirmed Inflammatory Pseudotumor(Fig. 12-15). The patient recovered uneventfully and remained asymptomatic at 6-month follow-up.

DISCUSSION

Double intussusception is extremely rare in adults. In this case, an inflammatory pseudotumor triggered an initial ileo-ileal intussusception, which subsequently served as the lead point for a second. The unusual etiology and configuration can pose diagnostic challenges, as radiological imaging may not fully reveal the complexity. Surgical intervention was required for definitive management.

CONCLUSION

Double ileo-ileal intussusception caused by an inflammatory pseudotumor represents an exceedingly rare etiology of acute intestinal obstruction in adults. Prompt surgical treatment is critical. This case highlights the importance of considering rare benign tumors as potential lead points in adult intussusception.

摘要

引言

成人肠套叠较为罕见,通常与潜在的引导点相关。炎性假瘤是一种病因不明的罕见良性病变,可作为小肠的此类引导点。在这种情况下发生的双重肠套叠极为罕见。

病例介绍

一名55岁女性出现小肠梗阻症状。影像学检查(图1 - 11)显示回肠 - 回肠套叠。术中(图16 - 18)观察到双重肠套叠结构,其中一个套入段作为第二个套入段的引导点。切除顶端的一个坚实病变。组织病理学证实为炎性假瘤(图12 - 15)。患者恢复顺利,6个月随访时无症状。

讨论

双重肠套叠在成人中极为罕见。在本病例中,炎性假瘤引发了最初的回肠 - 回肠套叠,随后该套叠又作为第二个套叠的引导点。这种不寻常的病因和结构可能带来诊断挑战,因为放射影像学可能无法完全揭示其复杂性。需要手术干预进行确定性治疗。

结论

由炎性假瘤引起的双重回肠 - 回肠套叠是成人急性肠梗阻极为罕见的病因。及时的手术治疗至关重要。本病例强调了在成人肠套叠中考虑罕见良性肿瘤作为潜在引导点的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0f/12205773/20c1c90e5869/gr1.jpg

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