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      Adult intussusception with cecal adenocarcinoma: Successful treatment by laparoscopy-assisted surgery following preoperative reduction.

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          Abstract

          We report a case of adult intussusception caused by cecal adenocarcinoma that was treated by laparoscopy-assisted ileocecal resection following reduction by contrast enema and preoperative colonoscopy. A 68-year-old male with cecal cancer was admitted to our hospital because of colicky abdominal pain after taking a laxative. His abdomen was distended, and a mass was palpable in the right upper quadrant, which appeared as a target- or sausage-shaped lesion by ultrasonograhpy and computed tomography. A contrast enema using water-soluble material showed a cup-shaped filling defect characterized by intussusception in the ascending colon. This round defect with a clear margin was pushed gradually back into the cecum by the enema pressure. Re-occurrence of the intussusception is easily released by colonoscopy. We performed laparoscopy-assisted ileocecal resection of a protruding tumor measuring 6.5 cm × 5.0 cm × 3.5 cm from the cecum, with D3 lymph node dissection. Histological examination revealed a well-differentiated adenocarcinoma that had invaded the serosa without permeating the lymphatic or venous capillaries, as well as lymph node metastasis. The postoperative course was uneventful, and the patient has been well without evidence of disease recurrence for 5 years following the operation. Preliminary reduction of adult colonic intussusception before surgical resection is therefore an option in cases of an early and correct diagnosis of intussusception.

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          Author and article information

          Journal
          World J Gastrointest Surg
          World journal of gastrointestinal surgery
          Baishideng Publishing Group Inc.
          1948-9366
          May 27 2012
          : 4
          : 5
          Affiliations
          [1 ] Tsutomu Namikawa, Takehiro Okabayashi, Kazuhiro Hanazaki, Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi 783-8505, Japan.
          Article
          10.4240/wjgs.v4.i5.131
          3364339
          22655128
          271c99ea-cc7d-4564-a39d-3aa2b67a3d7d

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