성인에서 나타난 일과성 소장 장중첩증 1예
A Case of Transient Small Intestinal Intussusceptions in an Adult
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
장중첩증은 장 일부가 원위부 장관 내로 유입되는 상태로 성인의 경우 전체 장중첩증의 5%에서 발생하는 드문 질환이다. 최근 영상 검사가 증가하면서 성인 소장 장중첩증의 진단이 증가하고 있고, 그 중 수술적인 치료가 불필요한 일과성 장중첩증인 경우 정확한 치료방향 정립이 무엇보다 중요하다. 성인 일과성 소장 장중첩증은 대개 증상이 없고 영상 검사에서 선행 병변이나 중첩 근위부의 소장 확장 소견이 보이지 않으며 특히 중첩 길이가 3.5 cm 이하일 경우 수술적인 치료 없이 보존 치료로 회복될 수 있다. 이번 증례는 성인에서 소장 장중첩증이 일시적으로 발생하였다가 대증 치료로 소실된 증례로서 문헌고찰을 통해 재조명하고자 한다.
Abstract
Intussusception occurs when a segment of the bowel invaginates into the lumen of an adjacent distal segment. Intussusception in adults is a rare disease, accounting for only 5% of all cases. Asymptomatic small bowel intussusception in adults without a lead point is usually transient. When the length of the intussusception is less than 3.5 cm, it can be managed conservatively. This case was an asymptomatic small bowel intussusception without a lead point, which was discovered incidentally during an abdominal computed tomography scan. Spontaneous reduction in the intussusception was observed without any complications while maintaining conservative treatment only.
참고문헌 (18)
- Azar T, "Adult intussusception", Ann Surg, 226, pp.134~138 (1997)
- Nagorney DM, "Surgical management of intussusception in the adult", Ann Surg, 193, pp.230~236 (1981)
- Reijnen HA, "Diagnosis and treatment of adult intussusception", Am J Surg, 158, pp.25~28 (1989)
- Weilbaecher D, "Intussusception in adults. Review of 160 cases", Am J Surg, 121, pp.531~535 (1971)
- Warshauer DM, "Adult intussusception detected at CT or MR imaging: clinical-imaging correlation", Radiology, 212, pp.853~860 (1999)
- Horton KM, "MDCT and 3D imaging in transient enteroenteric intussusception: clinical observations and review of the literature", AJR Am J Roentgenol, 191, pp.736~742 (2008)
- Agha FP, "Intussusception in adults", AJR Am J Roentgenol, 146, pp.527~531 (1986)
- Felix EL, "Adult intussusception; case report of recurrent intussusception and review of the literature", Am J Surg, 131, pp.758~761 (1976)
- Erkan N, "Intussusception in adults: an unusual and challenging condition for surgeons", Int J Colorectal Dis, 20, pp.452~456 (2005)
- Knowles MC, "Transient intussusception in Crohn disease: CT evaluation", Radiology, 170, pp.814~ (1989)
- Wood BJ, "AIDS-associated intussusception in young adults", J Clin Gastroenterol, 21, pp.158~162 (1995)
- Rea JD, "Approach to management of intussusception in adults: a new paradigm in the computed tomography era", Am Surg, 73, pp.1098~1105 (2007)
- Gayer G, "Intussusception in adults: CT diagnosis", Clin Radiol, 53, pp.53~57 (1998)
- Gayer G, "Pictorial review: adult intussusception--a CT diagnosis", Br J Radiol, 75, pp.185~190 (2002)
- Merine D, "Enteroenteric intussusception: CT findings in nine patients", AJR Am J Roentgenol, 148, pp.1129~1132 (1987)
- Doi O, "Twenty-one cases of small bowel intussusception: the pathophysiology of idiopathic intussusception and the concept of benign small bowel intussusception", Pediatr Surg Int, 20, pp.140~143 (2004)
- Catalano O, "Transient small bowel intussusception: CT findings in adults", Br J Radiol, 70, pp.805~808 (1997)
- Lvoff N, "Distinguishing features of self-limiting adult small-bowel intussusception identified at CT", Radiology, 227, pp.68~72 (2003)