Uncommon conditions in surgical oncology: acute abdomen caused by ileocolic intussusception

外科肿瘤学中的罕见疾病:回结肠套叠引起的急性腹痛

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Abstract

BACKGROUND: Bowel intussusception represents an infrequent and challenging condition in adult patients. Preoperative diagnosis and treatment strategies often remain difficult especially in emergency patients. Primary reduction of intussusception before surgical resection is discussed controversially in adult patients and at the moment there is no consensus about the best treatment in literature. CASE REPORT: We report the case of a 40-year-old male patient with a ten-day history of increasing colicky abdominal pain and constipation associated with nausea and vomiting. Clinical examination revealed acute abdomen with a palpable mass in the right upper abdomen. Ultrasonography and CT-scan showed typical signs of bowel intussusception. Emergency laparotomy and extended right hemicolectomy were performed. Histological examination detected an adenocarcinoma of the ileocecal valve as leading pathology. CONCLUSIONS: In adults most cases of intussusception are caused by structural lesions. The high incidence of malignancies in adult patients, which require an optimal oncological treatment, should be the main reason for primary surgical resection without reduction.

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