A Case with Intussusception of a Stump of Linear Stapler

Tsuyoshi Enomoto, Tsunehiko Maruyama*, Sakae Horiuchi* and Nobuhiro Ohkohchi**

Advanced Biomedical Applications, University of Tsukuba Graduate School of Comprehensive Human Science
Department of Surgery, Moriya Daiichi General Hospital*
Institute of Clinical Medicine, Gastroenterological Surgery, University of Tsukuba Graduate School of Comprehensive Human Science**

We report postoperative intussusception caused by the head portion of a linear stapler used in partial excision of the cecum. A 56-year-old man admitted for ileus due to sigmoid colon cancer underwent tube cecostomy to reduce intestinal pressure, followed by sigmoidectomy and closure of cecostomy. The cecum was partially excised by a linear stapler and the cecostomy was closed. The patient experienced intermittent abdominal pain on 4th post operative day (POD), and a fist-sized mass was palpated in the upper right abdomen. The linear stapler used for stumps of the partial excision of the cecum was found to be incarcerated into middle transverse colon and the emergency operation was carried out. At laparotomy, the head portion showed cicatrized stumps with the linear stapler forming a 7 cm mass, therefore we performed ileocecal resection under the consideration of the recurrence. In this case, dilatation of caliber difference of the ileocecal area which formed by ileus, oversewing cecal stump and mobility of cecum which induced by manipulation of closure of cecostomy likely caused the intussusception.

Key words
postoperative intussusception, linear stapler, postoperative complication

Reprint requests
Tsuyoshi Enomoto Advanced Biomedical Applications, University of Tsukuba Graduate School of Comprehensive Human Science
1-1-1 Tennodai, Tsukuba, 305-8575 JAPAN

Accepted
February 23, 2005

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