2016 Volume 36 Issue 4 Pages 791-795
This was a 71-year-old man hospitalized for stroke, in whom an ileus tube was placed for the diagnosis of ileus made after he developed vomiting and abdominal distention. He responded to the conservative treatment, and since a careful examination revealed no organic lesions that could have caused the ileus, we diagnosed paralytic ileus caused by long-term ingestion of antipsychotic drugs. The ileus recurred eight days after the removal of the ileus tube, and the ileus tube was re-inserted. The following day, the drainage from the ileus tube became bloody, CT revealed evidence of bowel intussusception, and emergency surgery was performed. Intraoperatively, the patient was found to have an antegrade intussusception on the anal side of the jejunum, with the balloon of the ileus tube advancing 20 cm into the anal side of the jejunum by the ligament of Treitz. The intussusceptum had become necrotic and a 150-cm long segment of the jejunum was excised. No lesions were found in the excised specimen that could have caused the intussusception, and we made the diagnosis of bowel intussusception due to ileus tube detainment. We are reporting this case as a rare example of bowel intussusception caused by an ileus tube placed for paralytic ileus in a patient with no history of abdominal surgery.
