A Case of Adult Intussusception Caused by a Small-intestinal Tubular Adenoma Associated with Superior Mesenteric and Portal Venous Thrombosis

Abstract

We present a case of superior mesenteric venous thrombosis (SMVT) induced by ileo-ileal intussusception. A 53-year-old man with no significant past medical history was referred to our hospital with the complaint of epigastric pain. Plain abdominal computed tomography (CT) revealed superior mesenteric vein (SMV) enlargement and mesenteric edema. Contrast-enhanced CT further revealed a thrombus in the SMV and ileo–ileal intussusception without impending bowel necrosis. We performed an emergency surgery and confirmed that the intestine was not necrotic. We resected the bowel segment containing the intussusception, which was caused by a hard, elastic mass measuring 2 cm in diameter and located 310 cm distal to the ligament of Treitz, and performed end-to-end anastomosis. Histopathology identified the tumor as a tubular adenoma. We administered heparin after surgery, but not thrombolytic therapy, as the intestine was not necrotic. The patient was discharged without complications on postoperative day 14. He did not have coagulation disorder; thus, the SMVT might have been caused by the intussusception in the absence of hereditary thrombophilia.