A Case of Gastroduodenal Intussusception without a Tumorous Lesion

Abstract

The patient was a 92-year-old man who was living in a care facility due to sequelae following a cerebral infarction. He was taken to the hospital by ambulance due to abdominal pain. Abdominal computed tomography (CT) showed portal venous gas, and he was immediately hospitalized. Three days after admission, the portal venous gas had disappeared on abdominal CT, but gastroduodenal intussusception was discovered incidentally. There was intussusception into the duodenum on upper gastrointestinal endoscopy, and emergency surgery was planned because the mucosa in the lead portion was somewhat blackish. Surgery was performed with laparotomy, and impaction of the gastric antrum to the duodenum was seen. Reduction was achieved with the Hutchinson maneuver following Kocher mobilization. A small incision was made in the anterior wall of the stomach, and the lead portion of the intussusception was checked, but only a chicken egg-size protuberance was seen in the gastric mucosa. The risk of recurrence was thought to be high, and a partial gastrectomy was performed. The patient's hemodynamic status became unstable during surgery, and he died on the second day postoperatively. On histopathological examination, there was only edema of the submucosal layer in the lead portion of the intussusception. This case of gastroduodenal intussusception in which no tumorous lesion was seen in the lead portion is reported.