A case of adult intussusception caused by primary cancer in small intestine

Abstract

A 76-year-old man developed progressive anemia during treatment for diabetes and was hospitalized for further investigation. No melena was observed, and upper gastrointestinal endoscopy and colonoscopy revealed no findings to indicate the cause of anemia. Abdominal contrast-enhanced computed tomography (CT) identified intussusception in the small bowel, but intestinal obstruction was not observed. A small bowel series─performed on suspicion of intussusception due to a small bowel tumor─revealed a protruded lesion in the jejunum. Enteroscopy confirmed the presence of the protruded lesion and biopsy results found it to be a papillary adenocarcinoma. Laparoscopic resection of a portion of the small bowel was subsequently performed to treat for small bowel cancer. The tumor was in a state of intussusception at the time of surgery and was resected after removing th-e invagination. Pathologically, the tumor was a papillary adenocarcinoma with a postoperative diagnosis of T3N1M0 in accordance with the general classification of stomach cancer. Adult intussusception is a rare pathology that is commonly caused by malignant diseases. The present case was diagnosed with the aid of CT, which identified the intussusception. Since small bowel cancer presents with few symptoms, investigation of anemia of unknown cause may lead to suspicion of small bowel diseases-demonstrating the importance of performing detailed examinations.