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成人陽套疊以罕見消化道出血表現:病例報告

Adult Intussusception with Gastrointestinal Bleeding:A Rare Presentation

摘要


成人腸套疊相較於小孩子的腸套疊是比較罕見的,而且常由一個誘導病灶(leading point)所促成。一個七十五歲男性病人,並沒有腸套疊典型腹痛、嘔吐等腸阻塞現象,卻以反覆消化道出血來表現。我們是在尋找出血病灶的系列檢查時,超音波發現典型腸套疊的箭靶象(target Sign)。電腦斷層除了證實這個診斷,同時也發現它的誘導病灶。剖腹探查時,在近端空腸處找到一問質腫瘤,手術切除後解決了腸套疊與出血的問題,由於腹部超音波的使用使得這難以早期診斷的病症得到診治。

並列摘要


While intussusception is a relatively common disorder in children, it rarely occurs in adults. A demonstrable leading point is almost always found in adult intussusception. We report a 75 year-old male who presented with recurrent hematochezia without symptoms of abdominal pain or vomiting. There was a typical ”target sign” on serial sonographic examinations. Surgery was performed for presumed intussusception. There was a gastrointestinal stromal cell tumor(GIST) over the proximal jejunum as the leading point of the intussusception. According to the literature, the diagnosis of adult intussusception is difficult because the presentation may vary considerably. Fortunately, we detected the disease easily in this case with sonography.

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