Ijaz Muhammad, Khalid Ibtissam Bin, Mahmood Umar, Amir Zainab, Shaukat Nabila, Cheema Fatima Amir
General Surgery, Mayo Hospital, Lahore, Pakistan.
General Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan.
Int J Surg Case Rep. 2025 Aug 28;135:111875. doi: 10.1016/j.ijscr.2025.111875.
Adult intussusception is rare, and its occurrence following colonoscopy-especially after multiple polypectomies-is exceptionally uncommon. This case highlights a rare post-endoscopic complication with implications for early diagnosis and management.
A 55-year-old man presented with abdominal pain, bloating, and nausea 24 h after colonoscopy with removal of nine polyps via cold snare technique. CT revealed ileocolic intussusception without a clear lead point. Conservative management failed. Exploratory laparotomy revealed an inflamed bowel segment at the polypectomy site. A right hemicolectomy with ileocolic anastomosis was performed.
Histopathology showed mucosal ulceration, mural abscesses, and submucosal oedema without malignancy-supporting inflammation as a transient lead point. Despite SLE and multiple comorbidities, early surgical intervention resulted in full recovery.
This case emphasises vigilant monitoring of high-risk patients post-polypectomy and the need to include intussusception in differential diagnoses of acute abdomen following colonoscopy.
成人肠套叠较为罕见,结肠镜检查后发生肠套叠,尤其是在多次息肉切除术后发生肠套叠的情况极为罕见。本病例突出了一种罕见的内镜后并发症,对早期诊断和治疗具有重要意义。
一名55岁男性在结肠镜检查并通过冷圈套技术切除9枚息肉24小时后,出现腹痛、腹胀和恶心症状。CT显示回结肠型肠套叠,无明确的套叠起始点。保守治疗失败。剖腹探查发现息肉切除部位肠段发炎。遂行右半结肠切除术及回结肠吻合术。
组织病理学显示黏膜溃疡、壁层脓肿和黏膜下水肿,无恶性病变,提示炎症为短暂的套叠起始点。尽管患者患有系统性红斑狼疮和多种合并症,但早期手术干预使其完全康复。
本病例强调了对息肉切除术后高危患者进行密切监测的重要性,以及在结肠镜检查后急性腹痛的鉴别诊断中需考虑肠套叠。