Ileus Caused by Ileal Invasion by Squamous Bladder Carcinoma: A Case Report

Abstract

An 87-year-old woman was admitted to the hospital because of ileus. Abdominal computed tomography showed an abscess and marked calcification in the pelvic cavity. The white blood count and C-reactive protein were respectively elevated to 13, 600/μl and 23.9mg/dl. Consciousness showed progressive impairment the second hospital day, when an emergency laparotomy was performed. Intraoperatively, the ileum showed invasion by bladder cancer, with abscess formation at the invasion site. Invasion of the uterus and metastasis to the peritoneum were also seen, and partial resection of the ileum, ileostomy, and peritoneal drainage were carried out. The pathologic diagnosis from examination of the resected intestine and a bladder biopsy specimen was squamous cell carcinoma of the bladder. Although this form of bladder cancer is relatively invasive, it rarely invades the intestine to cause ileus. In an elderly woman with acute abdominal pain and calcification in the pelvic cavity, the possibility of intestinal penetration by invasive bladder cancer should be considered.