[Ileal intussusception due to a voluminous inflammatory fibroid polyp. A case report and review of the literature].

Chirurgia italiana Pub Date : 2009-01-01
Lorenzo Sofia, Cesare Lorenzini, Francesca Pia Pergolizzi, Agata Foti, Eugenio Cucinotta
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Abstract

An inflammatory fibroid polyp is a rare benign submucosal lesion frequently located in the gastric antrum but it may be found anywhere in the gastrointestinal tract with maximal incidence in the fifth and sixth decades of life. The main histological characteristics are diffuse inflammatory infiltrate with eosinophils, high vascularisation and a myofibroblastic component. Its localisation in the small bowel can cause intestinal invagination in adults, a condition, that occurs most frequently in childhood where, however, it is generally not related to a pathological lesion. The diagnosis may often be delayed because of its non-specific symptoms and most cases are diagnosed at emergency laparotomy, although CT scans can furnish useful preoperative information. In the majority of cases, the treatment of choice is surgical resection. Reduction performed prior to resection proves controversial in patients with colic intussusception because of the high incidence of malignancy. We report a case of a 37-year-old man who had undergone emergency surgery for acute ileum intussusception associated with a voluminous inflammatory fibroid polyp. The case described emphasises that patients with bowel obstruction pose a complex and difficult challenge to surgeons as regards the choice of the correct diagnostic work-up and optimal therapeutic management.

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大体积炎性肌瘤息肉引起的回肠肠套叠。病例报告及文献综述]。
炎症性肌瘤息肉是一种罕见的良性粘膜下病变,通常位于胃窦,但它可以在胃肠道的任何地方发现,发病率最高的是在五六十岁。主要组织学特征为弥漫性炎症浸润,伴嗜酸性粒细胞,高血管化和肌成纤维细胞成分。它定位于小肠可引起成人肠内陷,这种情况最常见于儿童,但通常与病理病变无关。尽管CT扫描可以提供有用的术前信息,但由于其非特异性症状,大多数病例在紧急剖腹手术时诊断往往会延迟。在大多数情况下,治疗的选择是手术切除。由于恶性肿瘤的高发病率,在肠套叠患者切除前进行复位是有争议的。我们报告一位37岁的男性,因急性回肠肠套叠合并大量炎性肌瘤息肉而接受紧急手术。病例描述强调,肠梗阻患者对外科医生提出了一个复杂而困难的挑战,即选择正确的诊断检查和最佳的治疗管理。
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