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Intussusception secondary to endometriosis of the cecum
Authors:Hideki Katagiri  Alan Kawarai Lefor  Tetsuo Nakata  Toshikazu Matsuo  Isao Shimokawa
Affiliation:1. Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-32, Todaijima, Urayasu City, Chiba 279-0001, Japan;2. Department of Surgery, Jichi Medical University, 1-3311, Yakushiji, Shimotsuke City, Tochigi 329-0498, Japan;3. Department of Surgery, Ohmura City Municipal Hospital, 133-22, Kogashima-machi, Ohmura City, Nagasaki 865-8561, Japan;4. Department of Investigative Pathology, Graduate School of Biomedical Science, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, Nagasaki 852-8523, Japan
Abstract:

INTRODUCTION

Intussusception in adults is a rare cause of bowel obstruction. Endometriosis of the bowel is also a rare entity that can be the cause of bowel obstruction. Here, we report a rare case of intussusception secondary to endometriosis of the cecum.

PRESENTATION OF CASE

A 40-year-old woman presented to the hospital with a one-week history of intermittent epigastric pain. On physical examination, there was a soft, round non-tender palpable mass in the right flank and abdominal computed tomography scan revealed an intussusception. We made the diagnosis of ileo-colic intussusception and performed ileocecal resection. The surgical specimen revealed a round submucosal cystic mass in the cecum and the histology showed endometriosis of the cecum.

DISCUSSION

Intussusception in adults is a rare entity present in just 1% of all patients with bowel obstruction, and 5% of all intussusceptions. In general, intussusception in adults has a pathologic lesion as the lead point and the lesion is a malignancy in 20–50% of the cases. Thus, the treatment of an intussusception in adults should be operative. Endometriosis of the bowel is a rare cause of intussusception. Small endometriosis lesions of the bowel are unlikely to cause symptoms; however, in patients presenting with bowel obstruction, urgent treatment is indicated.

CONCLUSION

Intussusception in an adult is a rare cause of bowel obstruction and intussusception caused by endometriosis is also rare. Although rare, the diagnosis of endometriosis as a cause of intussusception must be considered as part of the differential diagnosis.
Keywords:Intussusception   Endometriosis of the bowel   Bowel obstruction
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