Secondary Small Bowel Volvulus in which Adult Intestinal Intussusception was Triggered by a Small Bowel Adipose Tumor

Abstract

A 51-year-old man was referred to our hospital because of a stomachache and vomiting. Contrast-enhanced abdominal computed tomographic imaging revealed intestinal intussusception, a low-absorption tumorous lesion, and a spirally revolving small intestine. We diagnosed the patient as having a small bowel volvulus and intestinal intussusception caused by a small bowel adipose tumor and performed emergency surgery. The laparotomy findings revealed a 270-degree torsion of the mesentery of the small intestine on the oral side at a point 70 cm from the ligament of Treitz and ischemic changes of the intestinal tract. Intestinal intussusception was also observed. During the reduction of the intussusception using Hutchinson's method, we felt a tumor of approximately 4 cm in the foward part. We performed a partial resection of the small intestine including the intussuscepted intestinal tract. The specimen revealed a yellowish pedunculated tumor in the jejunum, and a histopathological diagnosis of adipose tumor was made. The postoperative prognosis was good, and the patient was discharged on postoperative day 8. Only a few case reports have described secondary small bowel volvulus in which adult intestinal intussusception was triggered by a small bowel adipose tumor, making this particular case relatively rare.