A Case of Adult Intussusception Caused by Inverted Meckel's Diverticulum Involving Adipose Tissue on the Serosa

Goro Honda, Shigeki Oshima, Shuji Tada^*, Nobuyuki Shigaki, Mitsuhiro Arai, Seiji Mita and Keiki Sei

Department of Surgery and Department of Gastroenterology^*, Saiseikai Kumamoto Hospital

A 41-year-old man was admitted with a diagnosis of acute enterocolitis due to epigastralgia, vomiting and diarrhea that lasted 3 days. Computed tomography (CT) showed intussusception of the ileum into the ascending colon, which included a heterogeneous fatdensity mass in the center. We diagnosed intussusception caused by lipoma of the ileum. At laparotomy, we found intussusception that could not be restored, and partially resected the ileum. The protruding lesion of the resected ileum had a mushroom shape and lipoma-like yellow stump, leading to a macroscopic diagnosis of lipoma. Histologically, the lesion was the inverted wall of the ileum with ectopic mucosa of the stomach. Central adipose tissue of the lesion led to the mesntery, so we diagnosed intussusception caused by inverted Meckel's diverticulum involving adipose tissue on the serosa. Meckel's diverticulum occasionally inverts involving dipose tissue, so we must be careful to distinguish between inverted Meckel's diverticulum and lipoma.

Key words
Meckel's diverticulum, intussusception, Pseudo lipoma

Reprint requests
Goro Honda Department of Surgery, Saiseikai Kumamoto Hospital 5-3-1 Chikami, Kumamoto, 861-4193 JAPAN

Accepted
September 19, 2001

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