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结肠脂肪瘤继发成人结肠结肠套叠:一例报告

Adult Colocolic Intussusception Secondary to a Colonic Lipoma: A Case Report.

作者信息

Zubi Ahmed R, Atiyah Nabeel

机构信息

General Surgery, Indira Gandhi Memorial Hospital, Malé, MDV.

Internal Medicine, University of Tripoli, Tripoli, LBY.

出版信息

Cureus. 2025 Jul 24;17(7):e88694. doi: 10.7759/cureus.88694. eCollection 2025 Jul.

Abstract

Adult intussusception is uncommon and usually presents with nonspecific symptoms. Cross-sectional imaging is extremely important for diagnosis. In adults, a lead point is often present and indicates the underlying cause, which can be benign or malignant. Therefore, the primary treatment is surgical resection. Colonic lipoma, although rare, is a frequent benign lesion that leads to colocolic intussusception. This report describes a 42-year-old woman who presented with 12 days of intermittent abdominal pain and no other associated symptoms. After multiple emergency department (ED) visits, her symptoms were initially attributed to constipation, as physical examination revealed only mild right lower quadrant tenderness, routine blood tests were within normal range, and abdominal X-ray (AXR) showed stool loading in the right colon. Subsequent cross-sectional imaging revealed a colocolic intussusception caused by a 5 cm submucosal lipoma acting as the lead point. She underwent open segmental colectomy with a primary side-to-side stapled anastomosis and was discharged on postoperative day eight without complications. Histopathology confirmed the presence of a lipoma and an incidental serrated adenoma. This case highlights the diagnostic challenge and the importance of cross-sectional imaging in patients presenting with nonspecific abdominal pain. Intussusception should be considered in the differential diagnosis of adults with abdominal pain. Computed tomography (CT) is essential for timely diagnosis, and surgical resection remains the mainstay of treatment, particularly in colocolic involvement.

摘要

成人肠套叠并不常见,通常表现为非特异性症状。横断面成像对诊断极为重要。在成人中,常存在一个引导点,提示潜在病因,其可能是良性或恶性的。因此,主要治疗方法是手术切除。结肠脂肪瘤虽然罕见,但却是导致结肠结肠型肠套叠的常见良性病变。本报告描述了一名42岁女性,她出现间歇性腹痛12天,无其他相关症状。在多次前往急诊科就诊后,她的症状最初被归因于便秘,因为体格检查仅发现右下腹轻度压痛,常规血液检查在正常范围内,腹部X线平片显示右结肠有粪便积聚。随后的横断面成像显示,一个5厘米的黏膜下脂肪瘤作为引导点导致了结肠结肠型肠套叠。她接受了开放性节段性结肠切除术,并进行了端端吻合术,术后第8天出院,无并发症。组织病理学证实存在脂肪瘤和一个偶然发现的锯齿状腺瘤。本病例突出了诊断挑战以及横断面成像在出现非特异性腹痛患者中的重要性。在成人腹痛的鉴别诊断中应考虑肠套叠。计算机断层扫描(CT)对于及时诊断至关重要,手术切除仍然是主要的治疗方法,特别是在结肠结肠受累的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b073/12376000/5e235a5eaa16/cureus-0017-00000088694-i01.jpg

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