A Case of Adult Type Intussusception Induced by Ileus Tube after Operation of Colon Cancer

Koichi Kubota¹⁾²⁾, Hiroshi Takahashi¹⁾²⁾, Kenji Ogawa²⁾, Shunsuke Haga²⁾ and Tetsuro Kajiwara²⁾

¹⁾Depertment of Surgery, Nagareyama Central Hospital, ²⁾Department of Surgery, Tokyo Women's Medical University Daini Hospital

We report a case of intussusception induced by an indwelling ileus tube inserted to decrease pressure following ileus colon cancer surgery. A 52-year-old woman admitted for abdominal pain and vomiting had an ileus tube inserted due to suspected intestinal obstruction and leftcolectomy conducted for colon cancer. The tip of the ileus tube inserted in the end of the ileum with the balloon released, and the tube removed on postoperative day (POD) 4 after flatus was confirmed. That night, she experienced vomiting and distension and tenderness in the left abdomen. From enterography at tube reinsertion, we diagnosed postoperative intussusception of the jejunum. Operative findings showed 3-cylindrical antegrade intussusception, which we reduced manually, with no tumor, adhesion, twisting, or blood circulation disorder at the site. Since this case was antegrade and extension of the jejunum immediately before ileus tube removal was consistent with the intussusception site, we concluded that intussusception occurred during tube indwelling, base on operative findings and the position of the ileus tube, intussusception occurred when spasmodic constriction of the circular muscle due to peristalsis of the adoral jejunum impacted on the relaxed anal jejunum.

Key words
adult type intussusception, intussusception induced by ileus tube, intussusception after operation of colon cancer.

Reprint requests
Koichi Kubota Department of Surgery, Tokyo Women's Medical University Daini Hospital, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567 JAPAN

Accepted
December 12, 2001

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