Idiopathic Adult Intussusception : A Case Report

概要

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Adult intussusceptions account for 5-10％ of all intussusception cases and are considered rare,whereas they are most commonly encountered in children. Among adult cases, idiopathic intussusceptionsare pretty rare. A 36-year-old male was admitted to our hospital with abdominal pain. His bodytemperature was 37.0℃, the white blood cell count was 14,000/μl and CRP 0.01mg/dl. A standingabdominal X-ray showed slight niveau formation. Computed tomography demonstrated the multipleconcentric ring sign. His condition detoriorated and a laparotomy was performed. Intraoperatlvely,amass measuring six centimeters in diameter was seen in the left side of the hepatic flexure of the transversecolon. The diseased intestine was reducted with Hutchinson’s maneuver. No lesions or malignancywere found, however an ileocecal resection was performed to prevent recurrence of the intussusception.The resected specimen showed congestion and wall thickening. Pathological examination of resectedspecimen showed marked congestion and hemorrhage with coagulation necrosis. The patient’s postoperativecourse was uneventful and he was discharged from our hospital on the 10th postoperative day.After nineteen months’follow up,no recurrence of the intussusception has been seen. Reduction of thebowel followed by minimum bowel resection should be considered to prevent recurrence of the intussusceptionand to avoid short gut or adhesional ileus.
2012-05-01