A Case of Intussusception by Endometriosis of the Ileum

Keishi Aishin, Yoshihiro Sakashita, Yoshio Ogura, Naru Kondou, Norihumi Shigemoto and Yuka Ueda

Department of Surgery, Ohda Municipal Hospital

We report our experience in a patient who had ileocecal intussusception due to ileal endometriosis. A 40-year-old female was treated in the emergency department of this hospital (on an outpatient basis) for epigastric pain in October 2004; her symptom resolved with fluid therapy and she was sent home. On the following morning, the patient developed nausea and vomiting with worsening of the abdominal pain, and visited the emergency department of the hospital. Abdominal examination revealed right abdominal tenderness and positive Blumberg's sign. Abdominal ultrasonography revealed bowel hypoperistalsis in the right lower abdomen, intestinal dilatation and multiple concentric signs in the ileocecal region. Furthermore, emergency contrast CT revealed ascites and ileal swelling, Suggestive of strangulation ileus due to intussusception, and emergency surgery was performed. Hemorrhagic ascites was found in the abdominal cavity. A submucosal tumor was detected in the terminal ileum, which had intussuscepted into the Bauhin valve. The intussusception was manually reduced, and then ileocecal resection+D2 as conducted because of the possibility of malignancy. The excised specimen proved to be a submucosal tumor measuring 3 cm in size, and postoperative histopathological examination indicated the diagnosis of intestinal endometriosis.

Key words
intussusception, endometriosis, ileum

Reprint requests
Keishi Aishin Hiroshima City, Asa Hospital
2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293 JAPAN

Accepted
July 23, 2008

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