ความคิดเห็นทั้งหมด : 2

A 22 YOM with intermittent abdominal pain and hypochromic microcytic anemia

A previously healthy 22-year-old man presented with a 3-month
history of intermittent abdominal pain and hypochromic microcytic anemia, with a hemoglobin level of 5.1 g per deciliter and a mean corpuscular volume of 75 µm3. Initial endoscopy of the upper and lower gastrointestinal tract was unremarkable, despite a positive test for fecal occult blood. Further investigation with video-capsule enteroscopy showed an intraluminal bulge within the proximal jejunum 77 minutes after ingestion of the capsule.
Six days later, the patient presented with abdominal pain, nausea, and vomiting.
Computed tomography of abdomen was performed.

What is the diagnosis?

From N Engl J Med 2007; 357;26

Posted by : chpantip , E-mail : (chpantip@medicine.psu.ac.th) ,
Date : 2008-06-03 , Time : 15:59:33 , From IP : 172.29.3.68

ความคิดเห็นที่ : 1

CT abdomen finding : showed loops of bowel within-loop call "doughnut sign or target sign" (arrow point), no pneumoperitonial.

Diagnosis: Intussusception with Gut Obstruction

Posted by : Nongnham , E-mail : (Nongnham025@gmail.com) ,
Date : 2008-06-04 , Time : 07:02:23 , From IP : 117.47.181.111

ความคิดเห็นที่ : 2

คุณหมอ Nongnham เก่งมากค่ะ

ตอบ

Computed tomography showed the presence of an intussusception (arrow).
On emergency laparotomy, a proximal jejunojejunal intussusception was found and resected. Pathological examination revealed that the leading edge of the intussusception was a pedunculated benign lipomatous polyp. At a follow-up visit 2 months later, the patient was free of pain and had no further signs of bleeding.

From Wilson CH, White SA. N Engl J Med 2007; 357: e30.

Posted by : chpantip , Date : 2008-06-04 , Time : 16:36:18 , From IP : 172.29.3.68

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