44.關於腸套疊，何者正確？
(A)係指一小段腸管套入腸繫膜撕裂處所致
(B)其發生與腸管過度蠕動並無關聯
(C)瀕死前之腸套疊極易發生腸管壞疽
(D)動物死亡常是因內毒素休克所致

Basis P.442-443

屍體剖檢時必須謹慎區分具有臨床意義的生前腸套疊與死後形成的腸套疊，因為由於腸肌間神經叢（myenteric plexus）的作用以及平滑肌較低的能量需求，死亡後數小時內仍可能出現不協調的蠕動。生前腸套疊通常呈紅色、難以用手復位，且可見因發炎所形成的纖維蛋白血栓；而死後腸套疊則可輕易復位，幾乎不需費力，且沒有任何發炎證據。

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On rare occasions, antemortem intussusceptions spontaneously reduce by sloughing of the infarcted intussusceptum, which then passes in the feces. Often the site of sloughing is replaced with fibrous tissue, and a circumferential scar or stricture forms. Care must be taken at postmortem examination to distinguish clinically significant antemortem intussusceptions from intussusceptions that occur after death, because uncoordinated peristalsis can occur up to a few hours after death as a result of the action of the myenteric plexus and the low energy requirements of smooth muscle. An antemortem intussusception is reddened and difficult to manually resolve with fibrin thrombi resulting from inflammation. A postmortem intussusception simply and easily resolves with minimal effort and no evidence of inflammation.

瀕死前 (Agonal) 的腸套疊，是因為動物死亡前神經混亂導致腸管不正常蠕動，少見發炎、沾黏或壞疽等病變。通常是意外發現，而非造成死亡的原因。