A CASE OF ADULT IDIOPATHIC ILEOCOLIC INTUSSUSCEPTION DIAGNOSED PREOPERATIVELY

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This report describes a case of adult ileocolic intussusception of unknown origin that was preoperatively diagnosed. A 56-year-old man was admitted to the hospital because of a sudden onset of pain in the right inguinal region. Plain abdominal X-ray on admission showed multiple fluid levels and dilatated intestines. Abdominal ultrasono-graphy showed target like appearance. From these findings ileus due to intussusception was suspected and the patient was immediately operated on. The operative findings revealed ileocolic intussusception and a tumor of 2cm by 2cm at the ileum outside the intussusception. Then the ileac and colonic segments involved were resected. Histopathological findings for the tumor were consistent with these of submucosal lipoma. In case of adult intussusception some organic changes such as the presence of a tumor are often associated with the intussusception. In that case the leading point is mostly the organic change. But in our patient the lipoma at the ileum was not the leading point. From these observations, it was thought that the intussusception in this case was idiopathic. Preoperative diagnostic ultrasonography appears very useful as a diagnostic measure, because it is not invasive and easy to use.
日本臨床外科学会の論文