Triple Intussusception in an Adult-A Rare Presentation of Adenocarcinoma Ileum.

IF 0.8 Q4 SURGERY
Surgery Journal Pub Date : 2021-10-05 eCollection Date: 2021-10-01 DOI:10.1055/s-0041-1733834
Kirankumar P Jadhav, Gayathri Krishnan
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Abstract

Intestinal intussusception is uncommon in adults. It occurs more often in the small intestine than in the colon. In adults, when small bowel intussusception occurs, it can be due to a malignant lead point. Malignant etiology is most frequently due to diffuse metastatic disease. We present a rare case of an 18-year-old woman who was diagnosed with jejunojejunal, jejunoileal, and colocolic intussusceptions. She presented with vomiting, abdominal pain, and passage of semisolid stools for 5 days. During emergency exploratory laparotomy, multiple polyps were found in the jejunum, ileum, and sigmoid. Jejunotomy and sigmoidotomy were done to remove the respective polyps. The ileal polyp showed hemorrhagic changes; hence, an intraoperative decision was taken to proceed with resection and anastomosis. On histopathological examination, the resected ileal part showed moderately differentiated adenocarcinoma (grade 2) arising from an adenomatous polyp, while the jejunal polyp and sigmoid polyp were adenomatous polyps with low-grade dysplasia. Patient received six cycles of adjuvant chemotherapy consisting of capecitabine and oxaliplatin (CAPEOX regimen). After 2 years, she is symptom free with a normal colonoscopy. The treatment of intussusception in adults typically involves surgery, often with bowel resection as there is always a pathologic leading cause which may be malignant, like in our case.

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成人三叠肠套叠——回肠腺癌的罕见表现。
肠套叠在成人中并不常见。它更常发生在小肠而不是结肠。在成人中,当发生小肠肠套叠时,可能是由于恶性导点引起的。恶性病因多为弥漫性转移性疾病。我们提出一个罕见的情况下,一个18岁的妇女谁被诊断为空肠空肠,空肠回肠和结肠肠套叠。她出现呕吐、腹痛和半固体便排便5天。在急诊剖腹探查术中,在空肠、回肠和乙状结肠发现多发息肉。分别行空肠切开和乙状结肠切开切除息肉。回肠息肉呈出血性改变;因此,术中决定进行切除和吻合。在组织病理学检查中,切除的回肠部分显示由腺瘤性息肉引起的中分化腺癌(2级),而空肠息肉和乙状结肠息肉为腺瘤性息肉伴低级别发育不良。患者接受6个周期的辅助化疗,包括卡培他滨和奥沙利铂(CAPEOX方案)。2年后,患者无症状,结肠镜检查正常。成人肠套叠的治疗通常包括手术,通常是肠切除术,因为总是有一个病理性的主要原因,可能是恶性的,就像我们的病例一样。
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来源期刊
Surgery Journal
Surgery Journal SURGERY-
自引率
0.00%
发文量
64
审稿时长
12 weeks
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