A Case of Intussusception in an Adult due to Diverticulitis of the Terminal Ileum

Kazunori Shimada, Nobukazu Nakashima, Akira Ito and Masanobu Goto

Department of Surgery, Kawasaki Hospital

A 49-year-old man, who had previously undergone an appendectomy, was seen at our hospital because of a right lower abdominal pain. A diagnosis of ileus was made based on the results of an abdominal X-ray, and the patient underwent conservative therapy upon admission. A dull pain persisted in the right lower abdomen, and the ileus symptoms showed repeated remission and relapse. Abdominal ultrasonography and computed tomography (CT) examinations revealed target signs in the ascending colon. A barium enema showed a multiple nodular-filling defect. A colonoscopy revealed ileocolic intussusception. A primary tumor was not seen, and the biopsy showed no signs of malignancy. Since the intussusception could not be reduced by colonoscopic restoration, a laparotomy was performed under a diagnosis of ileocolic intussusception. At the time of surgery, an intussusception was not seen but an ileocecal mass the size of a fist was found. A right hemicolectomy was performed. Histological findings of the specimen revealed multiple diverticulitis of the terminal ileum. Therefore, we believed that the mass was caused by chronic inflammation of the diverticula and surrounding fibrosis.

Key words
intussusception, diverticulitis of the terminal ileum, adult

Reprint requests
Kazunori Shimada Department of Surgery, Ehime National Hospital 366 Yokogawara, Shigenobu-machi, Onsen-gun, Ehime, 791-0281 JAPAN

Accepted
April 30, 2003

To read the PDF file you will need Abobe Reader installed on your computer.