title: Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report.
abstract: Adult intussusception is rare and usually caused by a tumor acting as the lead point. Therefore, laparotomy should be considered for the treatment. Laparoscopic procedures for use in cases of adult intussusception have been recently reported; however, there is no consensus regarding the safety and efficacy. Here, we describe a successful case of laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma, which was preoperatively suspected. An 87-year-old male presented with progressive abdominal distention and vomiting. Contrast radiography of the small intestine showed an ileal tumor, and magnetic resonance imaging indicated a target-like mass, consistent with an ileal intussusception. The patient was suspected with an intussusception due to an ileal lipoma, and laparoscopic surgery was performed. An approximately 10-cm-long ileal intussusception with a preceding tumor was present, and partial resection of the ileum, including the tumor, was performed. Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma. The patient had an uneventful recovery and was discharged on postoperative day 8. This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.
authors.affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. shima-j@tokyo-med.ac.jp.
authors.forename: Jiro
authors.initials: J
authors.lastname: Shimazaki
authors.affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. kenken@tokyo-med.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakachi
authors.affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. warp0523@tokyo-med.ac.jp.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Tabuchi
authors.affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. ssuzuki@tokyo-med.ac.jp.
authors.forename: Shuji
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. h-ubu@tokyo-med.ac.jp.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ubukata
authors.affiliation: Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. tabuchi@tokyo-med.ac.jp.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tabuchi
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D019468:Disease Management; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D007443:Intussusception / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008067:Lipoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008297:Male; D011300:Preoperative Care; D011379:Prognosis