一例结肠肠套叠伴息肉切除术后电凝综合征病例及文献综述:结肠镜检查后如何处理肠套叠?

Kyung Hoe Kim, Joo-Seok Kim, Moon-Soo Lee, Hyun-Young Han, Joo Heon Kim
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引用次数: 0

摘要

据报道,成人结肠肠套叠通常与恶性肿瘤有关。众所周知,结肠镜检查本身加或不加息肉切除术是导致结肠肠套叠的罕见原因。我们遇到过一个病例,患者在接受结肠镜检查后被诊断为肠套叠。患者是一名 44 岁的女性,当天接受了结肠镜检查,包括内镜下升结肠息肉粘膜切除术。她因主诉右侧腹痛到急诊就诊。腹部检查发现右上腹有腹膜刺激症状。腹部 CT 显示肝曲附近有结肠肠套叠。怀疑是由息肉切除术后电凝综合征引起的。患者接受了腹腔镜右半结肠切除术,因为通过结肠镜进行肠套叠缩小术的风险很高,而且由于息肉切除术造成的额外水肿和缺血,肠套叠自发缩小的可能性也很低。患者在术后六天无并发症出院。虽然已有一些病例报道,但目前还没有针对结肠镜检查后肠套叠的治疗策略。因此,我们报告了这例结肠镜检查后结肠肠套叠的病例,并对其进行了文献综述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case of Colonic Intussusception with Post-polypectomy Electrocoagulation Syndrome and Review of Literature: How to Manage Intussusception Following Colonoscopy?

Colonic intussusception is often reported to be related to malignancy in adults. Colonoscopy itself with or without polypectomy is known to be a rare cause of colonic intussusception. We encountered a case in which an individual was diagnosed with intussusception following colonoscopy. The patient was a 44-year-old female who, on the same day, had undergone a colonoscopy including endoscopic mucosal resection for a polyp in the ascending colon. She visited the emergency room with complaints of right-sided abdominal pain. Abdominal examination revealed peritoneal irritation in the right upper quadrant. Abdominal CT revealed colocolic intussusception near the hepatic flexure. This was suspected to have been induced by post-polypectomy electrocoagulation syndrome. A laparoscopic right hemicolectomy was performed because conducting a reduction trial through colonoscopy involves a high risk of peritonitis, in addition to a low likelihood of spontaneous reduction of intussusception due to the additional edema and ischemia resulting from the polypectomy. The patient was discharged without complications six days after the surgery. Though some cases have been reported, there is no treatment strategy for intussusception following colonoscopy. Therefore, we report this case of colonic intussusception following colonoscopy, which was found to be caused by Post-polypectomy Electrocoagulation Syndrome, with a literature review.

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