结肠腺癌继发肠套叠1例报告并文献复习

A. Duda, M. Caparelli, Timothy S. Braverman, J. Cullen
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摘要

肠套叠在成人中很少见,约占肠梗阻病例的1%-3%。在此,我们报告一个由腺癌引起的乙状结肠肠套叠的病例。一名67岁男性因腹痛和直肠出血就诊于急诊科。计算机断层扫描(CT)显示肠套叠累及乙状结肠和潜在肿块。在手术室,患者接受了乙状结肠镜检查,随后进行了乙状结肠切除术和末端结肠造口术。切除标本病理检查证实乙状结肠中分化腺癌,边缘阴性,54个淋巴结中2个转移阳性。腹部重复CT扫描显示多个亚厘米低密度肝脏病变,活检证实转移灶。病人最终选择了临终关怀。本文报告一例罕见的成人乙状结肠肠套叠,回顾相关文献,总结适合成人肠套叠的诊断和治疗方法。
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Intussusception secondary to adenocarcinoma of the colon: A case report and literature review
Intussusception in adults is a rare occurrence, accounting for approximately 1%–3% of bowel obstruction cases. Here, we present a case of colocolic intussusception of the sigmoid colon caused by adenocarcinoma. A 67-year-old male presented to the emergency department with abdominal pain and rectal bleeding. A computed tomography (CT) scan revealed intussusception involving the sigmoid colon and a potential mass. In the operating room, the patient underwent flexible sigmoidoscopy, followed by sigmoidectomy and end colostomy. Pathological examination of the resected specimen confirmed moderately differentiated adenocarcinoma of the sigmoid colon with negative margins, and two of the 54 lymph nodes were positive for metastasis. A repeat CT scan of the abdomen showed multiple sub-centimeter low-density hepatic lesions, and biopsy confirmed a metastatic lesion. The patient ultimately elected hospice care. In this report, we describe a rare case of sigmoid intussusception in an adult patient, review the relevant literature, and summarize the diagnostic and management approaches suitable for adult intussusception cases.
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