脂肪瘤继发肠套叠2例

Two Cases of Intussusceptions Due to Lipoma

成人继发肠套叠属少见病例,临床表现缺乏特异性,术前诊断较为困难.内镜下所见肠套叠多表现为口唇或舌样,腊肠样肿物表面黏膜呈"螺旋弹簧"改变.结直肠脂肪瘤多无蒂、呈半球型,表面光滑或有溃疡形成、色泽微黄,质地柔软,Cushing征阳性.如瘤体较大引起黏膜脱垂则表现为腊肠样外观,可随压力在肠腔内滑动.内镜对肠套叠的定位及定性诊断具有一定价值,但通过内镜下活检明确肿瘤性质较为困难.

Secondary intussusception in adults is a rare case.There is no specific manifestation and preoperative diagnosis is difficult. The features of intussusception in colonoscope are like lips or tongue and the mucosal surface of the sausage-like masse is like ‘helical spring’.Most of colorectal lipomas are sessile or subpedunculated,with smooth or ulceration yellowish surface,whose textures are soft,and the Cushing′s sign of the lipomas are positive.If the tumor is large and causes mucosal prolapsed,the intussusception would have a sausage-like appearance and slide in the colon cavity due to the pressure.The colonoscopy for qualitative and locating diagnosis of intussusception has a certain value,but it is difficult to define lipoma′s properties by endoscopic biopsy.