A Case with Complication of Idiopathic Intussusception and Intussusception caused by Cecal Cancer

Tomoaki Takada¹⁾²⁾, Hideaki Yosida¹⁾, Morio Tsukada¹⁾, Shunichi Okushiba²⁾ and Hiroyuki Katoh²⁾

¹⁾Department of Surgery, Yoichi Kyokai Hospital
²⁾Second Department of Surgery, Hokkaido University School Medicine

The patient was a 79-year-old man who was hospitalized with a chief complaint of fever, vomiting, and upper abdominal pain. An abdominal tumor was palpated on the right side of the umbilicus. A plain film of the abdomen, abdominal ultrasonography, abdominal CT, colonoscopy, and a contrast enema led to a diagnosis of ileus secondary to herniation of a cecal cancer into an ascending colon-transverse colon intussusception. Emergency operation was performed. Laparotomy levealed a colon-colon type intussusception with the ascending colon as the leading end entering the right side of the transverse colon and a cecum-colon type intussusception with herniation of the cecum with containing a cecal cancer as the leading end. A mobile cecum was also found. Right hemicolectomy with the intussusception intact and D2 lymph node dissection were performed. The cecal cancer was type 2 and 5.5 cm×5.0 cm in size. Histologically, it was a well differentiated adenocarcinoma, stage II. No organic change that might have caused the intussusception was found at the leading end of the ascending colon, and it was considered idiopathic. We reviewed the 27 cases of adult intussusception caused by cecal cancer reported in the Japanese literature in the past decade, including the present case.

Key words
intussusception in adult, cecal cancer, idiopathic

Reprint requests
Tomoaki Takada Department of Surgery, Yoichi Kyokai Hospital 85 Kurokawa-cho, Yoichi-cho, Yoichi-gun, Hokkaido, 046-0003 JAPAN

Accepted
October 31, 2000

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