A CASE OF INTUSSUSCEPTION CAUSED BY A JEJUNAL SIDE-TO-SIDE ANASTOMOSIS IN THE LEAD IN AN ADULT

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  • 空腸側々吻合部が先進部となった成人腸重積症の１例

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Abstract

A 67-year-old man was admitted to the hospital because of the abrupt onset of intermittent abdominal pain. There were previous histories of undergoing distal gastrectomy with Billroth I reconstruction for gastric ulcer and two laparotomies for intestinal obstruction. On admission there was tenderness in the left lower quadrant of abdomen, but no palpable tumor and peritoneal signs were noted. Abdominal plain x-ray examination showed increased gas in the small intestine and air-fluid level formation. Abdominal CT scan revealed concentric lamellar structure involving the mesenteric vascular system in the left lower abdomen. Accordingly intussusception was diagnosed and a laparotomy was performed. The intussusception was caused by a leading portion, 4×5×3cm in dimension, and an excision of the small intestine including the portion was carried out. The leading portion was clarified to be the jejunal side-to-side anastomosis made in the former operation for intestinal obstruction.<br> Although intussuceptions occurred in adults are often caused by a tumor, non-anatomical intestinal anastomosis can rarely cause the disease. It is etiologically considered that adhesions surrounding the intussusception might contribute to the onset of intussusception in this case, and this case is presented here together with some bibliographical comments.

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