Hasegawa T, Ueda S, Tazuke Y, Monta O, Sakurai T, Takahara N, Tanaka T, Habukawa C
Division of Pediatric Surgery, Kinan General Hospital, Tanabe City, Wakayama, Japan.
Surg Today. 1998;28(3):301-4. doi: 10.1007/s005950050126.
This paper describes a 6-year-old boy with recurrent ileocecal intussusception due to lymphoid hyperplasia in the terminal ileum, which was diagnosed preoperatively by colonoscopy. At the age of 3 years, he developed diarrhea and a tender abdominal mass. He was diagnosed as having intussusception by ultrasound and was treated by hydrostatic barium enema. After resolution, he had three recurrent episodes of intussusception. A contrast barium enema revealed a small mass in the ileocecal region. Colonoscopy showed several exaggerated folds of the terminal ileum and a biopsy showed lymphoid hyperplasia. Because the repeated intussusception seemed to have been caused by the lymphoid hyperplasia in the terminal ileum, he underwent an ileocecal resection without any subsequent recurrence. Based on the above findings, we conclude that a colonoscopy may thus be useful both for diagnosing lymphoid hyperplasia in the terminal ileum as a cause of recurrent intussusception and for deciding how to manage it.
本文描述了一名6岁男孩,因回肠末端淋巴组织增生导致反复发生回盲部肠套叠,术前经结肠镜检查确诊。3岁时,他出现腹泻和腹部压痛性肿块。经超声诊断为肠套叠,并接受了水压灌肠治疗。症状缓解后,他又出现了三次肠套叠复发。钡剂灌肠造影显示回盲部有一个小肿块。结肠镜检查显示回肠末端有几个夸大的皱襞,活检显示淋巴组织增生。由于反复肠套叠似乎是由回肠末端的淋巴组织增生引起的,他接受了回盲部切除术,术后未再复发。基于上述发现,我们得出结论,结肠镜检查对于诊断回肠末端淋巴组织增生作为反复肠套叠的病因以及决定如何处理该病可能是有用的。