Adult Intussusception Caused by Long Intestinal Tube: A Case Report

Case Report

Austin J Surg. 2014;1(7): 1032.

Adult Intussusception Caused by Long Intestinal Tube: A Case Reporte

Shin Sasaki* and Emi Terai

Department of Surgery, Omori Red Cross Hospital, Japan

*Corresponding author: Shin Sasaki, Department of Surgery, Omori Red Cross Hospital, 4-30-1, Chuo, Ota-ku, Tokyo, 143-8527, Japan

Received: August 19, 2014; Accepted: September 06, 2014; Published: September 12, 2014

Abstract

We report herein in the case of a 92-year-old male who presented abdominal pain. Because he had several histories of adhesive ileus, and clinical and radiological examinations made a diagnosis of recurrent adhesive ileus, a long intestinal tube was instantly inserted. However, severe abdominal pain and several vomiting emerged on the 7th hospital day, and a computed tomography (CT) scan demonstrated an intussusception of small intestine. An emergency operation was performed and nearly 60 cm of small intestine was resected due to severe ischemia. We should keep in mind that a long intestinal tube can cause intussusception even though the frequency is low, and should perform examinations to treat immediately and properly in case of intussusceptions.

Keywords: Intussusception; Small intestine; Long intestinal tube; Ileus

Case Presentation

A 92-years-old man was transferred to our hospital with a chief complaint of abdominal pain. There were a previous history of a right hemicolectomy and an unknown operation for the treatment of colon cancer at ages 80 and 85, respectively. After the operation, he had several histories of adhesive ileus, which was successfully treated by a long intestinal tube. This time, an adhesive ileus was diagnosed by clinical and radiological examinations, and a long tube was instantly inserted. On the 7th hospital day, severe abdominal pain and several vomiting emerged. Furthermore, on the 9th hospital day, a serous bloody discharge was passed through the tube. An abdominal computed tomography (CT) scan showed an appearance of the target mass which was overriding of the third duodenal part to proximal jejunum and an abnormal accumulation of fluid were seen around the liver (Figure 1). Furthermore, contrast radiography of the intestine using gastrografin via the long tube was applied, and Coiled spring sign was demonstrated (Figure 2). When the tube was slightly pulled out, a severe stenosis in the upper jejunum was revealed. Consequently, an intussusception of small intestine caused by a long intestinal tube was diagnosed and an emergency operation was performed. Operative findings were consistent with the preoperative diagnosis. A fleshy sausage-like tubular intestinal mass, 20 cm in length, with severe ischemia was found and nearly 60 cm of small intestine was resected (Figure 3). Postoperatively, the patient had an intensive care, and discharged from the hospital on the 25th postoperative day.