An adult myasthenia gravis patient with idiopathic intussusception

Abstract

An 84-year-old man was admitted to our hospital with a 4-week history of dyspnea. Myasthenia gravis had been diagnosed 33 years earlier and the patient was being treated with anti-cholinesterase therapy after thymectomy. Bloody stool suddenly occurred five days after admission to our hospital and a mass was palpable in the right lower abdomen. Abdominal ultrasonography and computed tomography scan showed a ‘target sign’ in the ileocecum, and intussusception was diagnosed. An emergency operation was performed and revealed the ileocolic type of intussusception. Ischemic change was seen in the invaginated ileum, and ileocecal resection was therefore performed. No polyp or tumor or diverticulum which might have caused intussusception was found in the ileum. Idiopathic intussusception was thus diagnosed. Adult idiopathic intussusception is rare. Moreover, cases of myasthenia gravis with idiopathic intussusceptions are very rare.