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Se realizó una tomografía computarizada (TC) abdominal que mostró una lesión sólida gástrica indicativa de tumor del estroma gastrointestinal (confirmado mediante ecoendoscopia) y una imagen de masa en ciego (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>). En la colonoscopia se observó en el colon derecho una invaginación ileocólica (<a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>). Se intentó desinvaginación endoscópica sin éxito. La invaginación estaba asociada a una lesión de aspecto neoplásico tomándose biopsias que confirmaron un adenocarcinoma de colon.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Se realizó cirugía de ambos tumores en el mismo acto quirúrgico, tras lo que recibió quimioterapia y actualmente está asintomática.</p><p id="par0015" class="elsevierStylePara elsevierViewall">La invaginación ocurre cuando un segmento de intestino se introduce en otro contiguo. Es una entidad frecuente en niños (la mayoría idiopáticas) pero en adultos es rara. Suele ocurrir en el intestino delgado, representando el 1-5% de obstrucciones intestinales<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a>. La tríada clásica de dolor abdominal, masa palpable y heces en jalea de grosella, frecuente en niños, es excepcional en adultos en los que los síntomas son inespecíficos. Cuando ocurre en el intestino grueso, suele estar asociada a tumores malignos<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>. La prueba diagnóstica más útil es la TC<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a>; sin embargo, en ocasiones la colonoscopia desempeña un importante papel, permitiendo la toma de muestras consiguiendo el diagnóstico etiológico. El tratamiento habitualmente es quirúrgico.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicto de intereses</span><p id="par0020" class="elsevierStylePara elsevierViewall">Los autores declaran no tener conflictos de interés.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicto de intereses" ] 1 => array:1 [ "titulo" => "Bibliografía" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1000 "Ancho" => 905 "Tamanyo" => 118124 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sección coronal de la TC que muestra la invaginación intestinal (flecha grande) y una adenopatía regional (flecha pequeña).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 782 "Ancho" => 905 "Tamanyo" => 100471 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Imagen endoscópica que muestra la invaginación intestinal.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ileocolic intussusception caused by a lipoma in an adult" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.E. Lee" 1 => "J.Y. Choe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.12998/wjcc.v5.i6.254" "Revista" => array:6 [ "tituloSerie" => "World J Clin Cases" "fecha" => "2017" "volumen" => "5" "paginaInicial" => "254" "paginaFinal" => "257" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28685139" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intussusception due to rectal adenocarcinoma in a young adult: A case report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Inada" 1 => "T. Nagasaka" 2 => "T. Toshima" 3 => "Y. Mori" 4 => "Y. Kondo" 5 => "H. Kishimoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v20.i35.12678" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol." 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Journal Information
Imagen del mes
Invaginación ileocólica como forma de presentación de una neoplasia colónica
Colonic adenocarcinoma expressed as ileocolic intussusception
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María Calvo Iñiguez
, Vanesa Jusué Irurita, David del Pozo Prieto
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Servicio de Aparato Digestivo, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
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