RESUMO
The authors report two cases of colonic intussusception in the adult protruding from the anus--or colon-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.
Assuntos
Doenças do Ânus/diagnóstico por imagem , Doenças do Colo/diagnóstico por imagem , Intussuscepção/diagnóstico por imagem , Adolescente , Adulto , Anastomose Cirúrgica , Doenças do Ânus/patologia , Doenças do Ânus/cirurgia , Sulfato de Bário , Colectomia , Doenças do Colo/patologia , Doenças do Colo/cirurgia , Enema , Feminino , Humanos , Intussuscepção/patologia , Intussuscepção/cirurgia , Masculino , RadiografiaRESUMO
The authors report two cases of colonic intussusception in the adult protruding from the anus--or colo-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.
Assuntos
Doenças do Ânus/etiologia , Doenças do Colo/diagnóstico por imagem , Intussuscepção/diagnóstico por imagem , Doença Aguda , Adolescente , Adulto , Anastomose Cirúrgica , Doenças do Ânus/cirurgia , Sulfato de Bário , Doença Crônica , Colectomia , Doenças do Colo/complicações , Doenças do Colo/patologia , Doenças do Colo/cirurgia , Enema , Feminino , Humanos , Intussuscepção/complicações , Intussuscepção/patologia , Intussuscepção/cirurgia , Masculino , RadiografiaRESUMO
The authors present two cases of pseudo tumoral type Mucus Secreting Tumours (MST) of the appendix. In this type (32% of the cases), the clinical presentation, barium enema, ultrasonography and most importantly CT scan generally confirm the preoperative diagnosis. We found three advantages this preoperative diagnosis. 1) Primarily it allow selection of a large surgical approach that permits full exploration of the abdominal cavity especially the ovaries (2-18% associated lesions); 2) also it allows a histopathological examination (frozen section) of the appendix to be performed during the operation; 3) and finally the surgical treatment will depend on the operative findings and the result of the histopathological examination: in the benign forms simple appendicectomy will be sufficient but the malignant forms (12% of the cases) should be treated by right hemicolectomy.
Assuntos
Neoplasias do Apêndice/diagnóstico , Cistadenoma Mucinoso/diagnóstico , Neoplasias do Apêndice/diagnóstico por imagem , Neoplasias do Apêndice/patologia , Sulfato de Bário , Cistadenoma Mucinoso/diagnóstico por imagem , Cistadenoma Mucinoso/patologia , Enema , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Muco , Cuidados Pré-Operatórios , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
The authors present two cases of pseudo tumoral type Mucus Secreting Tumours (MST) of the appendix. In this type (32% of the cases), the clinical presentation, barium enema, ultrasonography and most importantly CT scan generally confirm the preoperative diagnosis. We found three advantages this preoperative diagnosis. 1) Primarily it allows selection of a large surgical approach that permits full exploration of the abdominal cavity especially the ovaries (2-18% associated lesions); 2) also it allows a histopathological examination (frozen section) of the appendix to be performed during the operation; 3) and finally the surgical treatment will depend on the operative findings and the result of the histopathological examination: in the benign forms simple appendicectomy will be sufficient but the malignant forms (12% of the cases) should be treated by right hemicolectomy.