THREE CASES OF INTUSSUSCEPTION ASSOCIATED WITH MALIGNANT INTESTINAL TUMORS

Three adult cases of intussusception associated with malignant tumors of the small intestine are reported. All of them had no history of previous laparotomy, and were diagnosed as intestinal obstruction on admission. The diangosis of intussusception was made by elective examinations following the bowel decompression therapy. The enterography of the oral side of the obstructive lesion showed a tapering shape of the intestinal lumen, which is a characteristic and specific finding of intussusception, and named as “pencil tip appearance”. Mesenteric arteriography was useful in making the diagnosis of intussusception, but it failed to demonstrate location or qualitative picture of the tumors. Most adult intussusceptions are associated with some causative organic diseases. It is often difficult to make definite diagnosis preoperatively that leads to emergency operation in considerable cases. From these experiences, it was clarified that the preoperative intestinal decompression therapy was effective and elective surgery was able to be performed. When we entertain a large probability of malignant primary lesion in adult intussusception, the significance that preoperative evaluation of the pathology can be achieved for an intestinal obstruction should be emphasized for better and more proper operative strategy.