A Case of Intussusception of the Sigmoid Colon in Adult Caused by an Elevated Cancer Lesion of the Sigmoid Colon Accompanied with Mesenterium Ileocecal Communei

Haruhiko Nagami, Katsuhiro Tamura*, Akira Nakase*

Department of Surgery, The Second Izumo City Hospital
*First Department of Surgery, Shimane Medical University

We report a case of intussusception of the sigmoid colon in a 74-year-old woman caused by an elevated cancer lesion of the sigmoid colon accompanied with mesenterium ileocecal communei. Irrigography on admission revealed intussusception of the sigmoid colon, but firstly she recieved conservative therapy. Irrigography at the 4th hospitalization day revealed a defected shadow of the sigmoid colon measuring 3 cm in size and obstruction of the sigmoid colon. Sigmoidectomy and resection of regional lymph nodes (R₂) were underwent to this patient under the diagnosis of cancer of the sigmoid colon (operative findings; H₀, P₀ N (-), S₀) and at the same time mesenterium ileocecal communei was recognized. Macroscopic findings of the resected specimen revealed a type 1 cancer of the sigmoid colon measuring 2.8 cm×2.8 cm in size and ulcer measuring 3 cm×4 cm in size derived from intussusception of the sigmoid colon and three small elevated lesions measuring 3 mm×4 mm around it. In our case intussusception is thought to be caused by local spasm of the sigmoid colon triggered by a type 1 cancer of the sigmoid colon (depth, pm) and as a result of the intestine with local spasm had intussuscepted into the dilated sigmoid colon. Also the good morbidity of the colon due to the presence of mesenterium ileocecal communei is thought to be one of the main factors producing intussusception.

Key words
cancer of the sigmoid colon, intussusception in adult, mesenterium ileocecal communei

Reprint requests
Haruhiko Nagami Department of Surgery, The Second Izumo City Hospital
238 Tiimiyachou, Izumo, 693 JAPAN

Accepted
November 19, 1990

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