RESUMO
This report describes the case of a young patient who underwent laparoscopic surgery to reduce for a retrograde intussusception of the sigmoid-descending colon caused by adenoma of the sigmoid colon. A 36-year-old woman visited our hospital, complaining primarily of vomiting and abdominal pain. Abdominal CT scan showed the typical finding of intussusception. An emergency colonoscopy revealed that the invaginated colon with a polypoid mass was protruding into the descending colon. A gastrografin enema showed the invaginated bowel segment at the descending colon. We performed endoscopic polypectomy and then hand-assisted laparoscopic reduction. The pathological finding showed tubular adenoma. Laparoscopy is a diagnostic or therapeutic tool for selected cases of adult intussusception. Benign tumor is one of the causes of intussusception in adults and a good indication for laparoscopic surgery.
Assuntos
Adenoma/complicações , Neoplasias do Colo/cirurgia , Colonoscopia/métodos , Intussuscepção/etiologia , Laparoscopia/métodos , Adenoma/diagnóstico , Adenoma/cirurgia , Adulto , Doenças do Colo/diagnóstico , Doenças do Colo/etiologia , Doenças do Colo/cirurgia , Neoplasias do Colo/complicações , Neoplasias do Colo/diagnóstico , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND/AIMS: Laparoscopy-assisted distal gastrectomy (LADG) is now being performed increasingly in Japan, while laparoscopic cholecystectomy (LC) is still the standard procedure used elsewhere in the world. However, there has been no report on simultaneous operation of LADG and LC. This study aimed to evaluate the combined use of these 2 procedures. METHODOLOGY: LADG was performed in 55 patients with early gastric cancer between January 2000 and December 2002. Seven of 55 patients (12.7%) simultaneously underwent LC. These 7 patients all presented with gallbladder stones (asymptomatic in 5, and symptomatic in 2). RESULTS: There was no conversion to conventional open surgery for all cases. Mean operation time and estimated blood loss were 359 +/- 61 min and 59 +/- 154mL, respectively. Time to walk independently was 1.5 +/- 0.6 days, time to first passage was 2.7 +/- 1.0 days, and postoperative hospital stay was 20.7 +/- 15.3 days. Only one of the 7 cases had minor complications of liver dysfunction and pancreatitis, which were treated conservatively. CONCLUSIONS: The simultaneous operation of LADG and LC is feasible and safe in patients with early gastric cancer and cholelithiasis.
