Adult Colonic Intussusception Caused by Mucinous Adenocarcinoma: Report of a Case

黏液性大腸腺癌引起的成人型大腸腸套疊

陳彥豪(Yen-Hao Chen) ； 王輝明(Hwei-Ming Wang) ； 陳周誠(Chou-Chen Chen)

《中華民國大腸直腸外科醫學會雜誌》 22卷1期 (2011/03) Pp. 20-24

https://doi.org/10.6312/SCRSTW.2011.22(1).09918

摘要

一位73歲的健康男性主訴有不規則的腹部陣痛，而且發現疼痛處位於左腹部。病人有噁心嘔吐伴隨腹漲的現象。所有生化檢查評估顯示正常，但是腹部電腦斷層資料指出在左下腹有明顯的大團塊。在剖腹手術後我們發現一個具有腫瘤的大腸腸套疊。腫瘤位於乙狀結腸並且套疊住了一部分的降結腸，因此左半結腸被切除以便分析。組織病理學檢查顯示為黏液性大腸腺癌。綜合以上的資料顯示，我們發現一個少見的因惡性黏液性大腸腺癌所引起的成人型大腸腸套疊案例。

關鍵字

大腸癌 ； 成人腸套疊

並列摘要

Adult colonic intussusception occurs infrequently and differs from childhood intussusception in its presentation, etiology, and treatment. Diagnosis can be challenging and may be delayed because of longstanding, intermittent, and non-specific symptoms. Most cases are diagnosed at emergency laparotomy. With more frequent use of computed tomography in the evaluation of patients with abdominal pain, the condition can be diagnosed more reliably. The effective management remains controversial. Treatment entails simple bowel resection in most cases. Reduction of the intussusception before resection is controversial, but there is a shift against this, especially in colonic cases. We present a case of a seventy-three-year-old healthy man who presented with a ten day history of recurrent generalized abdominal pain and obstructive symptoms. We present the classical CT appearance of intussusception, a classic target lesion, suggesting colonic intussusception (Descending-colon to Sigmoid-colon image), alongside intra-operative visual images highlighting this rare and extensive segment of D-colon intussuscepting to the proximal S-colon. Anterior resection (standard operation for S-colon cancer) was performed. Pathology showed a large mucinous adenocarcinoma with moderate differentiation sitting at the advancing tip of the intussuscepted fragments and hence acting as the lead point. Post-operatively, our patient has done well and there were no issues of concern.

並列關鍵字

Colon cancer ； Adult intussusception