Zhou Shengyue, Chen Zhiyi, Hu Yufei
Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China.
Sci Prog. 2025 Jul-Sep;108(3):368504251375713. doi: 10.1177/00368504251375713. Epub 2025 Sep 4.
Colonic intussusception after endoscopic submucosal dissection (ESD) is an uncommon, yet clinically significant complication. Therapeutic approaches for postoperative intussusception encompass conservative management, endoscopic reduction, and surgical intervention. We present a case involving a woman in her early 40s who experienced acute abdominal pain and fever shortly after ESD for a large ascending colonic adenoma. Contrast-enhanced computed tomography (CECT) of the abdomen confirmed intussusception without bowel ischemia. Immediate colonoscopic reduction was successfully performed, followed by conservative management. The patient achieved complete recovery with no recurrence at 3-month follow up. This case suggests that in patients developing post-ESD intussusception with no evidence of bowel necrosis or perforation, primary endoscopic intervention may be attempted and can be associated with favorable outcomes, potentially reducing the need for surgical management.
内镜黏膜下剥离术（ESD）后发生的结肠套叠是一种罕见但具有临床意义的并发症。术后套叠的治疗方法包括保守治疗、内镜下复位和手术干预。我们报告一例40岁出头的女性病例，该患者在因巨大升结肠腺瘤接受ESD后不久出现急性腹痛和发热。腹部增强计算机断层扫描（CECT）证实存在套叠且无肠缺血。立即成功进行了结肠镜下复位，随后进行保守治疗。患者在3个月的随访中完全康复且无复发。该病例表明，对于发生ESD后套叠且无肠坏死或穿孔证据的患者，可尝试进行初次内镜干预，且可能会有良好的结果，从而有可能减少手术治疗的需求。
