Minimally Invasive Surgery for Adult Intussusception Caused by Primary Mucinous Adenocarcinoma of Jejunum: Report of a Case
作者
Ming-Jenn Chen, Yun-Sheng Tai
卷期/出版年月
42卷6期 (2009/12)
頁次
329-333
摘要
Adult intussusception is an unusual cause of intestinal obstruction. In contrast to
children, intussusception in adults is usually due to a definable lesion. It is not
unusual for small bowel cancer to act as the lead point for adult intussuception.
Primary adenocarcinoma of the small bowel is a rare malignancy that challenges
surgeons in both diagnosis and treatment. The outcome is poor despite apparent
curative resection. We present the case of a 39-year-old man with the chief complaint
of nausea, severe vomiting and poor oral intake. No mass was palpable on physical
examination. Abdominal sonography showed a pseudokidney lesion in the left
pararenal region with a dilated proximal intestine. Abdominal computed
tomography revealed a pedunculate heterogenous mass lesion, 4cm in size, with a
target sign in the left flank area just beneath the left kidney. Small intestine
intussuception (jejuno-jejunal) was suspected. Laparoscopy confirmed the diagnosis
of jejuno-jejunal intussusception and segmental resection of the small bowel with
anastomosis was done extracorporeally. The final diagnosis was jejunal mucinous
adenocarcinoma. No recurrence or trocar metastasis was found in the 2 years of
follow-up.