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相關文獻
- 成人腸套疊之臨床經驗與分析
- Intussusception in Adults--A Report of 11 Cases
- Isolated Ileum Submucosal Lipoma Induced Intermittent Ileo-ileo-colic Intussusception: Report of a Case
- Colonic Intussusception in Adults
- Adult Intussusception: A 12-Year Experience, with Emphasis on Etiology and Analysis of Risk Factors
- Adult Intussusception--Unusual Presentation by a Solitary Hamartomatous Polyp in Association with Colonic Diverticula
- Enterocolic Intussusception in Adults
- Adult Enteric Intussusception: A Case Report and Review of the Literature
- Adult Intussusception--Analysis of 15 Cases
- 成人腸套疊
頁籤選單縮合
題 名 | 成人腸套疊之臨床經驗與分析=Clinical Experience and Analysis of Adult Intussusception |
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作 者 | 陳銘仁; 朱正心; 林錫泉; 高進祿; 周孫衍; 施壽全; | 書刊名 | 內科學誌 |
卷 期 | 9:4 1998.12[民87.12] |
頁 次 | 頁197-202 |
分類號 | 416.245 |
關鍵詞 | 腸套疊; 成人; 誘導病灶; Intussusception; Adult; Leading point; |
語 文 | 中文(Chinese) |
中文摘要 | 腸套疊在小孩子並不罕見,但卻甚少發生在成人。成人腸套疊幾乎都有一個明顯 的誘導病灶。因為症狀的不典型及多樣化加深了術前診斷的困難性。我們收集了馬偕紀念醫 院 14 年來,年齡大於十六歲,經開刀確定為腸套疊的 19 個病例,回溯性分析其基本資料 ,症狀,診斷工具及正確診斷率,病灶的成因與分佈,並比較各項診斷工具的優缺點與選擇 手術方式的考量。病人平均年齡是 52 歲。表現出來的症狀包括腹痛、嘔吐、消化道出血、 腹部腫塊、 腹膜炎跡象 (peritoneal sign)、便秘或腹瀉等。 使用的診斷工具抱括腹部 X 光平面攝影,腹部超音波,鋇劑灌腸,小腸系列攝影,電腦斷層和大腸鏡等。一共有 11 個 (58 % ) 病例在術前就診斷出腸套疊。 手術時 19 個病人的誘導病灶都被確認出來,其中 包括 15 個小腸和 4 個大腸的腸套疊。 所有小腸的病灶都是良性的,最常見的病因是脂肪 瘤。 相反的,4 個大腸病灶有 3 個是惡性的。腸套疊如果血管隨著腸道而套入則易因血流 阻塞而引起腸道水腫及缺血性壞疽變化,所以早期正確診斷的有其迫切性。成人腸套疊的治 療主要以手術為主。大腸的病灶因為高度惡性的可能性,以手術切除為上策。至於小腸的病 灶在切除術以前是否要進行復原術則依其病情而定。 |
英文摘要 | While intussusception is a relatively common disorder in children, it rarely occurs in adults. In contrast to intussusception in children, a demonstrable leading point is almost always found in adult intussusception. Due to the variable presentations, the preoperative diagnostic rate is relatively low. We enrolled and reviewed nineteeen patients older than 16 years with a postoperative diagnosis of intussusception at Mackay Memorial Hospital during the years 1984 through 1998. The patients' mean age was 52.1 years. Nine were male and ten were female. Presenting symptoms and signs included abdominal pain, nausea, vomiting, abdominal mass and GI bleeding. We correctly diagnosed 11 patients (58%) preoperatively using upper GI series, abdominal sonography, computed tomography, barium enema, and colonscopy. During surgery the leading point was identified in all 19 cases. There were 15 enteric and 4 colonic intussusceptions. All of the enteric lesions were benign, and the most common etiology was lipoma. On the contrary three of 4 colonic lesions were malignant. Fourteen patients underwent immediate resection and two patients who had had intussusception after previous surgery underwent simple reduction. The remaining three patients underwent resection after reduction. The treatment in the adult population is almost operative. Surgical resection is mandatory in colonic lesions because of the high probability of malignancy. Whether or not lesions in small intestine should perform reduction before reesection is controversial. |
本系統中英文摘要資訊取自各篇刊載內容。