2020 Volume 56 Issue 3 Pages 291-296
We report herein the case of a patient with rare jejuno-jejunal-type intussusception. A 12-year-old girl was admitted to our hospital because of bilious vomiting. She had abdominal pain and vomiting for three days prior to admission. A CT scan showed localized intestinal dilatation and ascites, indicative of strangulated obstruction due to an intestinal intussusception. An emergent laparotomy showed that the intestinal invagination of the lead point, which was found to be a jejunal polyp, extended 80 cm from the ligament of Treitz. She finally underwent extended resection of the necrotic intestine without performing enterostomy. For 18 months, the postoperative course was uneventful. A total of 17 cases of jejuno-jejunal-type intussusception secondary to an organic cause have been reported in Japan. We found that the intussusception frequently develops during school age, with the lead point being the pedunculated polyps (76%). Anemia is notably observed in five out of 15 patients without bloody stool. The length of the resected intestine is limited to less than 10 cm in five patients whose diagnosis was made less than 24 hours from the onset; however, extended resection of the intestine of more than 50 cm is inevitable in four patients whose diagnosis was delayed more than 24 hours (median, three days). Prompt recognition is paramount to make a correct diagnosis when one encounters abdominal pain and vomiting, even without bloody stool in school-age children.
