成人特发性肠套叠1例报告及文献复习。

Chirurgia italiana Pub Date : 2009-03-01
Giuseppe Pisano, Alessandro Manca, Stefania Farris, Alberto Tatti, Jenny Atzeni, Pietro Giorgio Calò
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引用次数: 0

摘要

成人肠套叠是一种罕见的疾病。大多数病例是由器质性病变引起的,与儿童的发病率不同,特发性形式确实很少见,占所有病例的5%。虽然在儿童中很少发现主要原因,但成人肠套叠通常以存在主要的腔内良性或恶性病变为特征。作者报告他们的经验与临床病例的回肠结肠肠套叠发生在一个28岁的白人男性。尽管患者年龄大,但临床表现非常典型,腹痛,直肠出血和可触及的肿块。诊断工具,即US和TC扫描,以及结肠镜检查证实了体格检查,因此在明确诊断为肠套叠的情况下开始手术。大息肉或淋巴瘤被认为是可能的主要原因。右半结肠切除术后病理显示无器质性病变,隆起肿块仅为内陷袢水肿及出血浸润所致。该患者已服用抗精神病药物数月,病理的可能解释与他所服用的药物引起的蠕动改变有关。作者将他们的经验与文献报道的数据进行比较,特别评估成人肠套叠的发病率、病理、临床表现、诊断和治疗。
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Adult idiopathic intussusception: a case report and review of the literature.

Adult intussusception is a rare condition. Most of the cases are due to an organic lesion and unlike the incidence in children idiopathic forms are really exceptional, occurring at a rate of 5% of all cases. Whereas in children a main cause is seldom found, adult intussusception is usually characterised by the presence of a leading intraluminal benign or malignant lesion. The authors report their experience with a clinical case of ileocolic intussusception occurring in an 28-year-old white male. In spite of the patient's age, the clinical presentation was very typical with the classic triad of abdominal pain, blood per rectum and a palpable mass. Diagnostic tools, namely US and TC scan, together with colonoscopy confirmed the physical examination, so that surgery was initiated with a definite diagnosis of intussusception. A large polyp or a lymphoma were considered the possible leading causes. After right hemicolectomy, pathology revealed that there was no organic lesion and the bulging mass was caused only by oedema and haemorrhagic infiltration of the invaginated loop. The patient had been on antipsychotic drugs for several months and the possible explanation of the pathology was linked to altered peristalsis induced by the pharmacological agents he was taking. The authors compare their experience with the data reported in the literature, evaluating in particular the incidence, pathology, clinical presentation, diagnosis and treatment of adult intussusception.

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