title: Intussusception secondary to endometriosis of the cecum.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-32, Todaijima, Urayasu City, Chiba 279-0001, Japan. Electronic address: x62h20k38@yahoo.co.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Katagiri
authors.affiliation: Department of Surgery, Jichi Medical University, 1-3311, Yakushiji, Shimotsuke City, Tochigi 329-0498, Japan.
authors.forename: Alan Kawarai
authors.initials: AK
authors.lastname: Lefor
authors.affiliation: Department of Surgery, Ohmura City Municipal Hospital, 133-22, Kogashima-machi, Ohmura City, Nagasaki 865-8561, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nakata
authors.affiliation: Department of Surgery, Ohmura City Municipal Hospital, 133-22, Kogashima-machi, Ohmura City, Nagasaki 865-8561, Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Matsuo
authors.affiliation: Department of Investigative Pathology, Graduate School of Biomedical Science, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, Nagasaki 852-8523, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Shimokawa
keywords: Bowel obstruction; Endometriosis of the bowel; Intussusception