成人肠套叠的诊治探讨

目的 探讨成人肠套叠的病因特点和诊治对策.方法 回顾性分析15例成人肠套叠的临床资料.结果 ①腹痛为最常见症状,共15例(100%),有腹部肿块者8例(53.3%),有血便者7例(46.7%);②术前确诊为肠套叠者6例(40%),肠梗阻13例(86.7%),腹部包块疑消化道肿瘤5例(33.3%),急性阑尾炎1例(6.7%);③引起肠套叠的病变有:小肠肿瘤7例(46.7%),小肠憩室2例(13.3%),盲肠游离症1例(6.7%),结肠肿瘤4例(26.7%)等;④本组均行剖腹手术治疗,术后无严重并发症,无死亡病例.结论 ①成人肠套叠大部分继发于小肠病变,且以小肠肿瘤最多见;②钡剂灌肠摄片、B超、纤维结肠镜有助于成人肠套叠的诊断,CT为最有诊断价值的检查;③治疗首选手术,腹腔镜也可以作为诊断与治疗的方法.

The investigation of diagnosis and treatment of adult intussusception

Objective To investigate the cause characteristics,diagnosis and clinical treatment of adult intussusception.Methods 15 cases with intussusception were retrospectively analyzed.Results ①Cases with abdominal pain in 15 cases（100%）,8 cases had a palpable abdominal mass（53.3%）,bloody stool in 7 cases（46.7%）.②Correct diagnosis was made for intussusception preoperatively in 6 cases（40%）.Other preoperative diagnosis included：intestinal obstruction in 13 cases,abdominal mass suspected as intestinal tumor in 5 cases（33.3%）,acute appendicitis in 1 cases ③Causes of adult intussusceptions：small intestinal tumor in 7 cases（46.7%）,intestinal diverticulum in 2 cases（13.3%）,＂cecum mobile＂syndrome in 1 cases（6.7%）,tumor of large intestine in 4 cases,et al.④A1l underwent laparotomy,all cases recovered uneventfully after operation.There was no mortality.Conclusion ①Most of the adult intussusceptions were secondary to primary lesion,and most of them were small intestine tumors.②Ultrasonography,barium enema and colonoscopy are helpful in diagnosing adult intussusceptions,computed tomography（CT）proved to be the most useful diagnostic method.③Operative management is the first choice,laparoscopic surgery can be used as the method to diagnose and treat the adult intussusception.