T1空腸癌による成人腸重積症の1例

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タイトル別名
  • A case of adult intussusception induced by T1 jejunal cancer
  • ショウレイ T1 クウチョウガン ニ ヨル セイジン チョウジュウ セキショウ ノ 1レイ

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A 34-year-old woman presented with sudden onset of epigastralgia and emesis. Abdominal computed tomography (CT) showed a mass that consisted of intussuscepted jejunum, demonstrating multiple concentric ring sign, in the upper abdomen. The intussuscepted jejunum was poorly enhanced and no tumor was seen in the lead point. Emergency operation was performed under the diagnosis of strangulated ileus. The oral side of the jejunum was intussuscepted into the anal side of the jejunum 35 cm in length, and 90 cm on the anal side from the Treitz ligament. A 105 cm length of jejunum was resected, and the intussuscepted area revealed blood flow disturbance. A type 0-Isp tumor with a diameter of 34 mm was found near the oral cut end. Histological examination revealed a tumor composed of well differentiated adenocarcinoma invading into the submucosal layer with vascular infiltration and no lymph node metastasis. The patient has been free from recurrence for 18 months following the surgery. We should consider the possibility of small bowel cancer in diagnosis and treatment of adult intussusception.

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