{"title":"内镜粘膜切除术后的结肠肠套叠通过内镜手术成功治愈。","authors":"Keiichi Hashiguchi, Shoichiro Mine, Junya Shiota, Taro Akashi, Maiko Tabuchi, Moto Kitayama, Kayoko Matsushima, Yuko Akazawa, Naoyuki Yamaguchi, Kazuhiko Nakao","doi":"10.1007/s12328-024-01953-8","DOIUrl":null,"url":null,"abstract":"<p><p>Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.</p>","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.8000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Colonic intussusception after endoscopic mucosal resection successfully managed by endoscopic procedure.\",\"authors\":\"Keiichi Hashiguchi, Shoichiro Mine, Junya Shiota, Taro Akashi, Maiko Tabuchi, Moto Kitayama, Kayoko Matsushima, Yuko Akazawa, Naoyuki Yamaguchi, Kazuhiko Nakao\",\"doi\":\"10.1007/s12328-024-01953-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.</p>\",\"PeriodicalId\":10364,\"journal\":{\"name\":\"Clinical Journal of Gastroenterology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Journal of Gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12328-024-01953-8\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12328-024-01953-8","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/20 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
成人肠套叠,尤其是与结肠镜检查相关的肠套叠极为罕见。一名 78 岁的男性因结肠内镜粘膜切除术(EMR)转诊至我院,随后出现腹部钝痛,外周血白细胞和 C 反应蛋白水平升高。腹部计算机断层扫描(CT)显示肝曲处有结肠肠套叠。急诊结肠镜检查显示,升结肠EMR部位远端粘膜呈球状肿胀。粘膜完好无损,没有坏死。内窥镜方法能够暂时解除肠套叠。为防止复发,通过内窥镜插入了经肛门引流管。CT 和结肠镜检查均显示肠套叠已经解除。我们的病例强调了在结肠镜检查后腹痛中考虑结肠肠套叠的重要性,主张在排除粘膜坏死后进行内镜治疗。
Colonic intussusception after endoscopic mucosal resection successfully managed by endoscopic procedure.
Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.
期刊介绍:
The journal publishes Case Reports and Clinical Reviews on all aspects of the digestive tract, liver, biliary tract, and pancreas. Critical Case Reports that show originality or have educational implications for diagnosis and treatment are especially encouraged for submission. Personal reviews of clinical gastroenterology are also welcomed. The journal aims for quick publication of such critical Case Reports and Clinical Reviews.