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Abstract: The patient, a 48-year-old female, reported vague abdominal pain for six months, and recently the discomfort had worsened, with occasional nausea and vomiting after eating, and her quality of life had significantly decreased, so she came to the hospital. After CT examination, the patient was diagnosed to have small intestinal stenosis. After detailed communication about her condition, she was given the option of surgery, after which her symptoms improved and her quality of life improved significantly.
Basic information】Female, 48 years old
Disease Type】Small Intestine Intussusception
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】February 2021
Treatment plan】Laparoscopic surgery
Treatment Period】2 days of hospitalization and 1 month of follow-up
Results】The patient’s symptoms improved significantly
I. Initial consultation
On Sunday morning, patient Cui came to my office. The pain was deeper than superficial, so she thought it was related to menstruation and kept observing the situation. However, about three months ago, the pain was slightly intensified, manifesting as occasional bouts of pain, sometimes getting worse and worse. Sometimes blood can be seen in the stool, which brings greater discomfort to life, so he came for examination.
After physical examination, the patient’s intra-abdominal mass-like substance was not found. Routine blood and urine tests showed no significant abnormalities in the patient’s indicators, but the white blood cells were slightly elevated. Through CT examination, it was found that the patient had localized jejunal wall thickening in the left upper abdomen, and the jejunal intestinal tube and mesentery could be seen in the intestinal cavity, and the proximal local intestinal tube had polyp-like material and obvious fluid accumulation, and the thickened intestinal wall showed relatively uniform enhancement after enhancement.
II. Treatment process
After detailed communication with the patient about his condition, the patient was suggested to undergo surgery, and at first the patient expressed some concerns, but after analysis of the pros and cons of surgery, he expressed willingness to undergo surgery. During the laparoscopic surgery, an obvious intestinal polyp was found at the site of intussusception, so the polyp was first removed by laparoscopic surgery and then the small intestine was repositioned, thus diagnosing the patient’s small intestine intussusception as caused by an intestinal polyp. After the operation, the patient was advised to rest in bed, abstain from food and water, and observe the patient’s condition.
III. Treatment effect
The patient’s symptoms were mild and lacked specificity, so the treatment time was delayed. However, the patient’s polyps were limited and slow-growing, and were examined as benign polyps, so the degree of secondary small bowel intussusception was mild, and the treatment effect of the operation was also very good. In addition, since the patient was in good health and did not have underlying diseases such as hypertension and diabetes, the patient was discharged after 2 days of admission and was asked to follow up for 1 month on an outpatient basis.
IV. Precautions
After the surgical treatment, the patient’s adverse symptoms disappeared and his physical condition continued to improve, which was really gratifying as a doctor. Since the patient underwent intestinal surgery, it is recommended that the patient be discharged with a liquid diet first, and then change to a semi-liquid or soft diet after the gastrointestinal function is stabilized, and then finally gradually resume a normal diet, with attention to a light diet and no cold, spicy or other stimulating foods. At the same time, patients should pay attention to the fact that if similar symptoms such as paroxysmal abdominal pain and blood in the stool occur again in the future, they must seek medical attention in time to prevent the recurrence of intestinal entrapment and even the local combination of intestinal obstruction and intestinal ischemic necrosis due to long-term untreated intestinal lesions.
V. Personal insight
Small bowel entrapment mainly occurs in young children under 2 years of age, and in adults it is rarely primary, but mostly secondary to pathological changes in the intestinal tract, such as intestinal polyps, tumors or diverticula. As in this case, the cause of small bowel intussusception is intestinal polyp. When treating the patient, the specific cause of this condition should be clarified and communicated to the patient, which will help in the subsequent prevention for this.