2013 Volume 38 Issue 5 Pages 1042-1046
An 81-year-old man visited our hospital with chief complaints of nausea and vomiting. The abdominal symptoms were mild, and examinations other than CT showed no evidence of abnormalities. Abdominal CT revealed that the small intestine had invaginated into the right colon and its wall had thickened to show “a target appearance.” These findings led to a diagnosis of ileocecal intussusception into the ascending and transverse colon with strangulation ileus, and the patient underwent emergency surgery. Laparotomy showed distension of the large intestine with the intussusceptum and small bowel volvulus at the ileocecal junction. The intussuscepted intestine was reduced into the ascending colon, and right colectomy, including the twisted small intestine, was performed. The resected specimen showed no organic lesions, but revealed that a 30cm segment of the ileum had undergone hemorrhagic necrosis. We speculate that the mobile cecum induced intussusception with secondary small bowel volvulus. In adults, intussusception is most often due to an organic lesion, and the idiopathic form is rare. This case is very rare in that the intussusception was not associated with an organic lesion, and was complicated by small bowel volvulus.
