PMC8256994_01
(A) Abdominal CT scan first noticed intestinal obstruction with sign of air-fluid level instead of intussusception. (B) Transverse section of CT scan indicated intussusception with sign of "target-like" or "concentric double ring" (both are indicated by white arrow above).
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F1
CT scan was completed few days later, which disclosed the sign of proximal enterostenosis instead of direct intestinal intussusceptions based on partial air-fluid level (Figure 1A). Conservative treatment, such as insertion of a gastric tube, NPO, and nutrition support was carried out for next the 4 days, but somatic complaints have not been visibly alleviated yet. CT scan was performed to evaluate for nosogenetic factors of intestinal obstruction again, which pointed out the apparent sign of "target-like" or "concentric double ring," revealing the objectivity of intestinal intussusceptions (Figure 1B).
(A) Antegrade intussusception was observed directly through laparoscopic operation. (B) An intraoperative incision was made after laparoscopy in order to ascertain that adhesion among focal walls is restored, and that the layer of injured bowel serosa would be sutured integrally.
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F2
A 3D-laparoscopic exploratory operation and subsequent reduction were performed after excluding operative contraindication, which revealed antegrade intussusception that the proximal bowel invaginated into distal segment incidentally (Figure 2A). No intestinal ischemia or necrosis was noticed after returning to physiological morphology (Figure 2B).
Small incisions (indicated by red arrow above) derived from laparoscopy and an inverted T-shape surgical incision caused by liver transplantation were revealed clearly.
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F3
The process described that the surgery featured with a small incision accompanied with mild trauma was different from conventional laparotomy (Figure 3).