超高齢者に発生した特発性多発腸重積と考えられた一例

A 94-year-old woman visited our hospital with chief complaints of abdominal pain, nausea, and vomiting by way of her local clinic. Abdominal MDCT revealed a target sign of the small intestine, and its frontal section showed invagination of the oral intestinal tract into the anal intestinal tract, which led to a diagnosis of adult small intestinal intussusception. The abdominal symptom was minor, and no ischemic and necrotic manifestations of the intestinal tract were observed. Conservative treatment was considered. However the patient was oldest-old with dementia, and her consent to the long-term conservative treatment seemed unlikely to be obtained, as well as the small intestine had intussusception extending more than at least１０cm, and its natural reduction was judged to be difficult. Therefore an urgent operation was selected. Two places in the small intestine showed intussusceptions, which could be relatively easily reduced. Because the entire intestinal tract had no abnormalities such as mass and necrotic lesions, the intestine was not resected. Postoperatively, the patient had dementia symptoms such as wandering and abnormal behavior, but her postoperative course was good, leading to hospital discharge on the seventh postoperative day. We report the case of idiopathic multiple intestinal invagination that has never been reported in the past, with some literature review.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html