Abstract
A 73-year-old man with no history of abdominal surgery visited our hospital with a chief complaint of abdominal pain. He was admitted after a diagnosis of ileus was made on abdominal computed tomography (CT). Intestinal decompression was performed by inserting a decompression tube. Contrast-enhanced imaging using the decompression tube showed findings suggesting obstruction of the ileum by a tumor, and surgery was indicated. Laparoscopic observation of the abdominal cavity confirmed obstruction of the ileum by a tumor, which was exposed on the serosal side and infiltrated the transverse colon. White nodules suggesting peritoneal dissemination were seen throughout the abdominal cavity. Following conversion to laparotomy, partial resection of the ileum and transverse colon was performed. Some of the white nodes were removed for biopsy. On pathological examination, an adenocarcinoma was seen suspended in a large amount of mucus in the tumor and white nodes, and a diagnosis of mucinous adenocarcinoma of ileal origin, classified as se, n0, H0, P3, M0 stage 4, was made. The patient had no complications and was discharged, and he has been undergoing chemotherapy as per colon cancer guidelines on an outpatient basis. In cases of small intestinal ileus without a history of laparotomy it is considered necessary to perform decompression using a decompression tube and detailed examination, given the possibility, albeit small, of ileus secondary to primary small intestinal cancer.
