A CASE OF INTUSSUSEPTION IN ADULTS CAUSED BY LONG TUBE FOR ILEUS AND A REVIEW OF 4 CASES REPORTED IN JAPAN

Recently we have carried out emergency operation on a patient with postoperative adhesive ileus who developed intussusception of the small intestine following insertion of an ileus tube. The patinet was a 91-year-old woman who had undergone laparotomy in the treatment of gallstone 10 years previously. She was admitted for ileus, and underwent aspiration with an ileus tube. Although her symptoms initially imporved, abdominal pain, fever and intestinal hemorrhage occurred on the 10th hospital day, and she underwent surgery because of suspected strangulated ileus. During surgery, 3-segmental antrograde intussusception was found in both the jejunum ileum, and the tip of the ileus tube was located on the anal side of the ileal intussusception. The ileal intussusception could be repaired manually, whereas partial resection of the small intestine was needed for the jejunal intussusception because of the presence of necrotic changes. In this case, the ileus tube presumably induced the intussusceptions. In using an ileus tube either for aspiration or prevention of postoperative ileus, full attention should be paid to possible changes in the patient's symptoms and the properties of the drained fluid.