Adult Intussusception Secondary to Lymphangioma of the Cecum: A Case Report

我們報告了一個盲腸淋巴管瘤誘發成人腸套疊發生的案例。一位45歲的男性病患因為每天多次的水瀉合併間歇性腹痛，且症狀已持續二個月，而來到本院求診。大腸鏡檢發現一個盲腸黏膜下腫瘤合併黏膜潰瘍及盲腸的部分阻塞，二天後此病人因為腹痛加劇而入院。理學檢查發現右腹壓痛但無腹膜炎徵象，雙重對比劑下消化道攝影檢查顯示右側結腸阻塞處有鋸齒狀顯影及病灶邊緣鳥嘴狀顯影特徵，腹部電腦斷層檢查發現有右腹腹腔內腫塊合併香腸狀特徵，高度懷疑腸套疊。病人隨後接受了右半結腸切除術，術後病理診斷證實是腸套疊合併盲腸淋巴管瘤，病人術後恢復良好並在本院定期追蹤。這個病例彰顯了結腸淋巴管瘤也是誘導成人腸套疊發生的可能導引點病灶之一，而臨床醫師在面對及處理成人腸套疊的狀況時也應將此病灶列入可能的診斷。

關鍵字

盲腸；腸套疊；淋巴管瘤

並列摘要

We report the case of a patient with ileocolic intussusception caused by cecal lymphangioma. A 45-year-old man visited our hospital with a 2-month history of frequent episodes of watery diarrhea (≥5 times / day) and intermittent abdominal pain. A cecal submucosal tumor with mucosal ulceration and partial obstruction of the colonic lumen was identified by colonoscopy. He was admitted to our hospital 2 days later due to aggravation of his abdominal pain. Physical examination revealed tenderness over the right abdomen with no peritoneal signs. A double-contrast lower gastrointestinal series showed a right-side colonic lesion with indentation and a peripheral, beak-like sign. Abdominal computed tomography scanning revealed an intra-abdominal mass with the characteristic sausage sign, highly suggestive of intussusception. The patient subsequently underwent right hemicolectomy. The final diagnosis was ileocolic intussusception with cecal lymphangioma, which was confirmed by histopathology. He had an uneventful recovery with follow-up in our hospital. This case highlights the possibility of colonic lymphangioma as the leading point of adult intussusception, and this should be taken into consideration as a possible diagnosis in this uncommon clinical condition.

並列關鍵字

cecum ； intussusception ； lymphangioma

國際替代計量

Adult Intussusception Secondary to Lymphangioma of the Cecum: A Case Report

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