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題名 | Adult Intussusception: A 12-Year Experience, with Emphasis on Etiology and Analysis of Risk Factors=成人腸套疊:12年之臨床經驗--特別強調病因學及分析其危險因子 |
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作者 | 黃武雄; 張簡吉幸; 盧勝男; | 書刊名 | 長庚醫學 |
卷期 | 23:5 2000.05[民89.05] |
頁次 | 頁284-290 |
分類號 | 415.552 |
關鍵詞 | 成人腸套疊; 電腦斷層攝影; 腸阻塞; Adult intussusception; Computed tomography; Intestinal obstruction; |
語文 | 英文(English) |
英文摘要 | Background. To determine the incidence, causes, and associated risk factors of adult intussusception. Methods. Forty-five cases of adult intussusception proven by surgery were collected from 58,000 surgeries performed from December 1986 through December 1998. The condition leading to intussusception, imaging studies, and clinical risk factors were analyzed. Results. Nineteen men and 26 women, 18 to 83 years of age (mean, 52.6 years), experienced intussusception. The incidence of adult intussusception was 0.08% of abdominal surgeries and 3.0% of intestinal obstructions. A benign process was diagnosed in 25 cases (55.6%), malignancy in 16 cases (35.6%), surgery-related intussusception in 1 case (2.2%), and an idiopathic condition existed in 3 cases (6.6%). The major cause of adult intussusception due to benign lesions was polyps (12/25) and for malignancy, it was colonic adenocarcinoma (14/16). The diagnostic imaging rates were 52% for computed tomography, 41% for barium studies and 32% for abdominal ultrasound. There was no mortality due to intussusception; 4 patients (8.9%) died of colon cancer with liver metastasis. No definite risk factor was identified, but leukocytosis and a shorter preoperative duration tended to increase the risk of complications (p=0.084, 0.082 respectively). Conclusion. Malignancy was the major cause of colonic intussusception, as was a benign process the primary cause of intestinal intussusception. These adult patients with intussusception received adequate surgical care and had a good prognosis except for those with colon cancer and liver metastasis. |
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