成人伯基特淋巴瘤致肠套叠1例

Olivia Makenzie Boyette, B. Casey, Stephanie Tom, Todd N Tom
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摘要

肠套叠的定义是一个肠区向邻近的肠区延伸。我们提出一个有趣的病例逆行肠套叠由于潜在的伯基特淋巴瘤。病例介绍:我们有一个41岁的白人男性谁提出到急诊科(ED)的投诉左侧脐周腹痛,开始几个月前。腹部和骨盆的计算机断层扫描(CT)与口腔和静脉造影剂显示结肠肿块在回盲瓣区域。病人没有发烧、呕吐、黑黑或便血。他被安排进行外科结肠镜检查。结肠镜检查发现回盲瓣区域出现肠套叠,当天安排行盲肠切除术。通过手辅助腹腔镜盲肠切除术和功能性端对端吻合术切除肠套叠。盲肠切除术后标本的大体解剖显示一个5cm × 5cm的肿块作为肠套叠的主要点(图4,5)。该肿块被送去病理检查,结果显示为Burkitt淋巴瘤。结论:肠套叠是一种罕见的成人腹痛的原因,但应考虑,因为它可能是潜在的恶性肿瘤的一个指标。小儿患者的肠套叠可以非手术治疗,而成人患者的治疗通常是手术。
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Intussusception Induced by Burkitt Lymphoma in an Adult Patient
Intussusception is defined as the telescoping of an intestinal region into an adjacent region of intestine. We present an interesting case of a retrograde intussusception due to an underlying Burkitt lymphoma. Case Presentation: We have a 41-year-old Caucasian male who presented to the Emergency Department (ED) with complaints of left sided periumbilical abdominal pain that began several months prior. Computed tomography (CT) scan of the abdomen and pelvis with oral and IV contrast showed a colonic mass in the region of the ileocecal valve. Patient denied any fever, vomiting, melena, or hematochezia. He was scheduled for a colonoscopy with surgical services. Upon colonoscopy, intussusception in the region of the ileocecal valve was discovered and cecectomy was scheduled for the same day. Intussusception was removed via hand assisted laparoscopic cecectomy with functional end-to-end anastomoses. Gross dissection of the specimen post cecectomy revealed a 5cm by 5cm mass as the lead point for intussusception (Figures 4, 5). The mass was sent for pathology which revealed Burkitt lymphoma. Conclusion: Intussusception is a rare cause of abdominal pain in adults but should be considered because it may be an indicator of underlying malignancy. Unlike intussusception in the pediatric patient, which can be managed non-operatively, treatment in adults is usually surgery.
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