A Case of Intussusception in Adult due to Submucosal Intra-abdominal Desmoid Tumor of the Ileum

Yoshihiro Nabeya¹⁾, Hiroshi Nakamura¹⁾, Hideji Konno¹⁾, Tsuyoshi Hirashima²⁾, Chung Chieh Chu³⁾, Taro Iga⁴⁾, Koichi Nagao⁵⁾

¹⁾Department of Surgery, Kamogawa Municipal Hospital
²⁾Chiba Prefectural College of Health Science
³⁾Second Department of Surgery, Chiba University
⁴⁾Iga Hospital
⁵⁾Department of Surgical Pathology, Ichihara Hospital of Teikyo University

The patient was a 79-year-old woman who was admitted to our hospital with chief complaints of acute abdominal pain, nausea and vomiting. From the findings of plain abdominal x-ray, ultrasonography, computed tomography and other procedures, intussusception was suspected. At first, a suction tube was inserted for decompression but improvement was not seen. Five days later, an emergency operation was performed. The operative finding revealed an ileocaecal intussusception, and ileocaecal resection followed by end-to-end anastomo-sis was carried out, as manual reposition was difficult. The resected specimen revealed a pedunculated polypoid submucosal tumor, measuring 3.5×3.0×2.5 cm, in the ileum about 20 cm from the ileocaecal valve, which was the lead point of the intussusception. Histological diagnosis was a submucosal intra-abdominal desmoid tumor. The patient was free of polyposis coli. This is thought to be the 16th case of a sole intra-abdominal desmoid tumor as well as the first case in which intussusception developed in the Japanese literature. The postoperative course was satisfactory and the patient was discharged from the hospital on the 31st day after the operation. The usefulness of preoperative imaging techniques, particularly ultrasonography, for diagnosing intussusception should be emphasized.

Key words
intra-abdominal desmoid tumor, intussusception in adult, ultrasonography for diagnosis of intussusception

Reprint requests
Yoshihiro Nabeya Department of Surgery, Kamogawa Municipal Hospital
233 Miyayama, Kamogawa, 296-01 JAPAN

Accepted
April 17, 1991

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