症例報告超高齢者に発生した特発性多発腸重積と考えられた一例

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A 94-year-old woman visited our hospital with chief complaints of abdominal pain, nausea, andvomiting by way of her local clinic. Abdominal MDCT revealed a target sign of the small intestine,and its frontal section showed invagination of the oral intestinal tract into the anal intestinal tract,which led to a diagnosis of adult small intestinal intussusception. The abdominal symptom was minor,and no ischemic and necrotic manifestations of the intestinal tract were observed. Conservativetreatment was considered. However the patient was oldest-old with dementia, and her consent tothe long-term conservative treatment seemed unlikely to be obtained, as well as the small intestinehad intussusception extending more than at least１０cm, and its natural reduction was judged to bedifficult. Therefore an urgent operation was selected. Two places in the small intestine showedintussusceptions, which could be relatively easily reduced. Because the entire intestinal tract hadno abnormalities such as mass and necrotic lesions, the intestine was not resected. Postoperatively,the patient had dementia symptoms such as wandering and abnormal behavior, but herpostoperative course was good, leading to hospital discharge on the seventh postoperative day. Wereport the case of idiopathic multiple intestinal invagination that has never been reported in thepast, with some literature review.
2012-04-25