A Case of Lymphangioma of the Ileum Presenting with Intussusception

Wataru Onozato, Takatoshi Nakamura, Kazuhiko Hatate, Heita Ozawa, Takeo Satou, Yukihito Kokuba, Atushi Ihara and Masahiko Watanabe

Department of Surgery, Kitasato University School of Medicine

A 55-year-old woman. Experiencing abdominal pain and vomiting after lunch and initially diagnosed with bowel obstruction and treated conservatively elsewhere by intestinal tube insertion had worsening abdominal pain 5 days after onset. Extreme overall abdominal tenderness and rebound tenderness were accompanied by a fist-sized mass palpated in the right lower quadrant. Enhanced abdominal Computed Tomography (CT) indicated target signs in the ileocecum suggesting peritonitis due to intussusception and necessitating emergency surgery. Perioperative findings confirmed ileal-ileal-colonic intussusception. The large dark red sausage-like mass found in the ileocecum could not be manual by repositioned, necessitating ileocecal resection. The resected specimen was a submucosal tumor 2.7 cm long located 54 cm from the distal ileum. Meckel's diverticulum was noted 20 cm from the distal ileum. Histopathology confirmed lymphangioma of the ileum. Lymphangioma of the small intestine is so rare that only 36 cases have been reported in Japan. Given that only 6 such cases involved intussusception, our case is extremely rare. Lymphangioma of the small intestine should thus be considered in cases of intussusception in adoults.

Key words
lymphangioma of small intestine, intussusception, Meckel's diverticulum

Reprint requests
Wataru Onozato Department of Surgery, School of Medicine Kitasato University
1-15-1 Kitasato, Sagamihara, 228-8555 JAPAN

Accepted
January 31, 2007

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