癒着性イレウス術後イレウス管が誘因で発症した成人型腸重積症の１例

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  • A Case of Adult Intussusception of the Small Intestine after Lapalotomy due to Adhesional Ileus Probably Caused by an Ileus Tube.

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Recently we experienced an adult case of postoperative intussusception probably caused by an indwelt ileus tube. A 70-year-old man was admitted to the hospital for adhesive ileus which developed 85days after having undergone a distal gastrectomy for early gastric cancer. Conservative therapy under indwelling ileus tube was inffective. An operation was performed on the 17th hospital day and adhesions were separated, but an ileus tube was left in the jejunum for postoperative bowel decompression. The ileus tube was removed immediately on the third postoperative day, when intermittent vomiting and upper slight abdominal pain occurred and persisted. From findings of a roentogenogram on the 7th postoperative days (POD), and abdominal CT on the 8POD, intussusception was suspected and another operation was performed on the 10POD. Antegrade intussusceptions located 10 and 120cm from the Treitz ligament were found during surgery, and they were resected because the intussusceptions were associated with ischemia and necrosis. It should be considered that intussusception can occur when a long tube is used for aspiration or prevention of postoperative ileus, though it is uncommon.

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