Minimally Invasive Surgery for Adult Intussusception Caused by Primary Mucinous Adenocarcinoma of Jejunum: Report of a Case

Abstract

Adult intussusception is an unusual cause of intestinal obstruction. In contrast to children, intussusception in adults is usually due to a definable lesion. It is not unusual for small bowel cancer to act as the lead point for adult intussuception. Primary adenocarcinoma of the small bowel is a rare malignancy that challenges surgeons in both diagnosis and treatment. The outcome is poor despite apparent curative resection. We present the case of a 39-year-old man with the chief complaint of nausea, severe vomiting and poor oral intake. No mass was palpable on physical examination. Abdominal sonography showed a pseudokidney lesion in the left pararenal region with a dilated proximal intestine. Abdominal computed tomography revealed a pedunculate heterogenous mass lesion, 4cm in size, with a target sign in the left flank area just beneath the left kidney. Small intestine intussuception (jejuno-jejunal) was suspected. Laparoscopy confirmed the diagnosis of jejuno-jejunal intussusception and segmental resection of the small bowel with anastomosis was done extracorporeally. The final diagnosis was jejunal mucinous adenocarcinoma. No recurrence or trocar metastasis was found in the 2 years of follow-up.