阑尾息肉引起的特发性肠套叠:病例报告

Mazen Kurdi
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引用次数: 0

摘要

导言原发性或继发性肠套叠是婴幼儿机械性梗阻的常见原因。病例介绍 一位三十二个月大的女性因腹痛和排出红醋栗果冻便而被送到急诊科。腹部检查发现上腹部可触及肿块。腹部超声波检查显示出回结肠肠套叠的典型体征:横切面的目标征和纵切面的假肾征。患者接受了静水钡灌肠减容术。看到造影剂回流到回肠,证实肠套叠已成功缩小。然而,几小时后腹痛再次出现,随访超声检查显示肠套叠再次复发。患者被送往手术室进行探查性开腹手术。在手动切除肠套叠后,发现阑尾底部有一个可触及的肿块突出到盲肠。我们在盲肠靠近阑尾底部的位置进行了肠切开,发现一个息肉从阑尾内部突出到盲肠。我们进行了阑尾切除术,其中包括息肉。患者恢复顺利。结论阑尾息肉虽然罕见,但可作为回盲部肠套叠的导引点。这种类型的肠套叠可能会在缩小灌肠后复发,可能需要进行手术探查。
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Idiopathic intussusception caused by a polyp in the appendix: A case report

Introduction

Intussusception, primary or secondary, is a common cause of mechanical obstruction in infants and children. Rarely, however, an intussusception is caused by a lesion of the appendix.

Case presentation

A thirty-two-month-old female was brought to the emergency department with abdominal pain and passage of red currant jelly stool. The abdominal exam revealed a palpable mass in the upper abdomen. Ultrasound examination of the abdomen showed the classical signs of an ileocolic intussusception: target sign in the transverse view and pseudokidney sign in the longitudinal view. A hydrostatic barium enema reduction was done. Successful reduction of the intussusception was confirmed by seeing the contrast reflux into the ileum. However, several hours later the abdominal pain recurred, and a follow-up ultrasound showed recurrence of the intussusception. The patient was taken to the operating room for an exploratory laparotomy. Following the manual reduction of the intussusception, a palpable mass was identified at the base of the appendix protruding into the cecum. An enterotomy was made on the cecum near the base of the appendix, and a polyp was found protruding from the inside the appendix into the cecum. We did an appendectomy, which included the polyp. The patient recovered uneventfully. The pathology analysis was consistent with a juvenile polyp.

Conclusion

Although rare, appendiceal polyps can serve as a lead point for intussusception of the ileocecal region. Such type of intussusception may recur after a reduction enema and may require a surgical exploration.

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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
期刊最新文献
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