Abstract
A 65-year-old woman consulted a local physician because of gradually intensifying abdominal pain. Intussusception was suspected on computed tomography of the abdomen, and the patient was referred to our hospital. Abdominal ultrasonography showed a target sign in the left side of the abdomen. Contrast-enhanced computed tomography of the abdomen revealed a tumorous lesion in the ileocecum that had invaginated into the descending colon close to the splenic flexure. Intussusception was diagnosed, and surgery was performed on the same day. Laparoscopic reduction of the intussusception was attempted with a forceps, however, it was difficult to secure an adequate field of vision of the invaginated intestine. The procedure was therefore converted to open surgery, and the intussusception was reduced by Hutchinson's maneuver. The cecum showed a submucosal tumor-like appearance. Because a possibility of malignancy could not be ruled out, ileocecal resection with D3 dissection was performed. A black tumor 5 cm in diameter was found in the resected cecum. Histopathologically, the lesion was associated with pronounced bleeding, necrosis, and degeneration. Multiple emphysematous cysts and fibrosis were present in the submucosal stroma. Pneumatosis cystoides intestinalis was thus diagnosed. The patient progressed satisfactorily, and she was discharged from the hospital on the 7th postoperative day. The patient has been alive without recurrence as of 3 years after the operation.
