A case of intussusception developed at the site of ileocolic anastomosis after laparoscopic right hemicolectomy

• Published in: BMC surgery 2019-07, Vol.19 (1), p.74-74, Article 74
• Main Authors: Hayama, Tamuro, Hashiguchi, Yojiro, Ohno, Kohei, Okada, Yuka, Nemoto, Kentaro, Yagi, Takahiro, Tsukamoto, Mitsuo, Fukushima, Yoshihisa, Ozawa, Tsuyoshi, Shimada, Ryu, Okamoto, Koichi, Tsuchiya, Takeshi, Nozawa, Keijiro, Matsuda, Keiji
• Format: Article
• Language: English
• Subjects: Analysis; Cancer; Care and treatment; Case Report; Case studies; CAT scans; Colectomy; Complications and side effects; Development and progression; Diagnostic imaging; Functional end-to-end anastomosis; Gastrointestinal diseases; Health aspects; Intestinal obstruction; Intussusception; Laparoscopic surgery; Laparoscopy; Postoperative complications; Surgery; Surgical anastomosis; Tomography; Tumors
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-019-0539-z

Intussusception is a relatively common condition seen in children. In comparison, adult intussusception is rare and usually occurs as a complication in patients with organic diseases. It is responsible for 1% of all bowel obstructions, in most of intussusceptions a malignant tumor is involved. Herein, we present an extremely unusual case of intussusception that occurred as a complication at the site of a functional end-to-end anastomosis. A 57-year-old female patient was diagnosed with tumors in the ascending and descending colon and was referred to our department. Laparoscopic hemicolectomy and laparoscopic descending colectomy were performed. The mechanical intestinal obstruction occurred on the 9th day postoperatively, and computed tomography scan revealed intussusception at the site of the ileocolic anastomosis. Endoscopic reduction was attempted, but the procedure was challenging. Surgery was then performed and revealed that the site of ileocolic anastomosis firmly adhered to the side wall and right retroperitoneum. However, the intestine in the oral side of the anastomosis was not fixed. Examination of the anastomotic site revealed that the ileum had passed through the anastomosis and prolapsed into the transverse colon. The ileocolic anastomosis was resected. End-to-end anastomosis was performed, and surgery was then completed. No neoplastic lesions were observed in the resected tissue of the lead point of intussusception. The postoperative clinical course was favorable, and the patient was discharged on the 11th day after the second round of surgery. There are no reports the anastomosis is involved as part of the intussception, as observed in the present case. Intussusception should thus be considered as one of the causes of postoperative mechanical intestinal obstruction.