A Case of Idiopathic Intussusception in an Adult

Yukihiro Itabashi^{1) 2)}, Toshiaki Baba^{1) 2)}, Satoru Kato¹⁾ and Mutsuo Sasaki²⁾

Department of Surgery, Kizukuri Adult Disease Medical Center¹⁾
Department of Second Surgery, Hirosaki University School of Medicine²⁾

A 36-year-old woman admitted for crampy abdominal pain and a movable mass in the right abdomen was discharged after 10 days of fasting but no definite cause for pain determined. She reported to the emergency outpatient clinic the next day with severe abdominal pain. Ultrasonography and CT of the abdomen showed stratified invaginated intestinal walls in the abdominal mass. She was not in acute distress and there was no sign of peritoneal irritation. One day later, she passed bloody stool and her serum CPK rose to 1,003 IU/L, necessitating emergency laparotomy. The abdominal mass was intussuscepted intestinal wall. The terminal ileum was the leading head, forming ileocecal intussusception. Hutchingson's maneuver to reduce intussusception was successful but strong edema and fibrinous adhesions between the serous surfaces of the entering and emerging walls of the intussusceptum necessitated right hemicolectomy. The ascending colon had a free mesocolon and was not fixed to the retroperitoneum. No causative lesion that could have acted as the leading head was identified in the resected bowel segment. The absence of fixation of the ascending colon may be a related etiologic factor. Idiopathic intussusception was the final diagnosis. The postoperative course was uneventful and she was discharged on postoperative day 18.

Key words
idiopathic intussusception, adult

Reprint requests
Yukihiro Itabashi Department of Second Surgery, Hirosaki University School of Medicine
5 Zaifu-cho, Hirosaki, 036-8562 JAPAN

Accepted
July 28, 2004

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