A Case of Adult Intussusception Caused by Completely Inverted Appendix

Tadashi Matsumoto, Osamu Uemichi, Kazuyoshi Ishibashi, Takehiro Umemoto, Kenji Hibi, Yasuo Yoshizawa, Genshu Tate* and Yutaka Sanada

Department of Surgery and Department of Pathology*, Showa University Fujigaoka Hospital

A 78-year-old man, admitted for left upper quadrant abdominal pain and diarrhea was found to have a movable, tender hard mass in the left upper abdomen. We diagnosed intussusception based on gastrografin enema and computed tomography. Although gastrografin enema did not reduce the intussusception, it showed ileocolic intussusception and a completely inverted appendix on the cecum, necessitating emergency surgery. Intra-operative findings indicated that the right colon was not fixed to the retroperitoneum. The cecum was at the leading head, forming ileo-left transverse colonic intussusception, necessitating right hemicolectomy. No causative acting as the leading head was identified in the resected segment, except for the completely inverted appendix at the cecum. The post operative course was uneventful and the man was discharged on operative day 11. We speculated that both the unfixed right colon and appendix intussusception caused ileocolic intussusception.

Key words
adult intussusception, intussusception of the appendix, inverted appendix

Reprint requests
Tadashi Matsumoto Department of Surgery, Showa University, Fujigaoka Hospital
1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501 JAPAN

Accepted
March 28, 2007

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