Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report
| Autor: | Mayu Sakata, Takafumi Kawamura, Yoshihiro Hiramatsu, Hirotoshi Kikuchi, Kiyotaka Kurachi, Kosuke Sugiyama, Yoshifumi Morita, Kyota Tatsuta, Toshiya Akai, Katsunori Suzuki, Hiroya Takeuchi, Yuhi Suzuki |
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| Rok vydání: | 2020 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Abdominal pain medicine.diagnostic_test business.industry medicine.medical_treatment Perforation (oil well) Transverse colon Case Report medicine.disease Idiopathic intussusception Surgery Bowel obstruction 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Intussusception (medical disorder) Pediatric surgery Emergency surgery medicine Laparoscopy 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Surgical Case Reports |
| ISSN: | 2198-7793 |
| DOI: | 10.1186/s40792-020-01077-4 |
| Popis: | Background Adult intussusception is recognized as an abdominal emergency. More than 90% of adult patients with intussusception have distinct causes that are related to benign or malignant tumors. In contrast, idiopathic intussusceptions, which are observed in children, are rare conditions in adult. Especially, colo-colonic idiopathic intussusceptions are rare among them. Surgery is traditionally considered the primary treatment option. Recently, laparoscopic surgery has been reported to be safe and feasible. However, laparoscopic surgical reduction, which is a common procedure in pediatric surgery, is not common in adult intussusception. Case presentation We report a 34-year-old man who presented with sudden abdominal pain. Computed tomography revealed the target sign in the transverse colon. There was no evidence of bowel obstruction, bowel wall edema, or tumor. We diagnosed idiopathic intussusception and selected laparoscopic procedure because of the strong abdominal pain experienced by the patient. There were no signs of perforation, bowel wall ischemia, or tumor in abdominal cavity. We confirmed idiopathic colo-colonic anterograde intussusception. Laparoscopic surgical reduction was achieved by a combination of delicate direct pressure on the anal side of the transverse colon and gentle pulling on the oral side. The patient’s postoperative course was uneventful. Conclusions We achieved successful surgical reduction laparoscopically because of an accurate preoperative diagnosis based on characteristic computed tomography features and appropriate surgical technique. Laparoscopic procedure and surgical reduction is considered to be an effective treatment strategy for adult idiopathic intussusceptions with severe symptoms. |
| Databáze: | OpenAIRE |
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