TWO CASES OF INTUSSUSCEPTION OF THE SMALL INTESTINE PROBABLY CAUSED BY INDWELLING ILEUS TUBE

We experienced two cases of intussusception of the small intestine probably caused by an indwelling ileus tube. Patient 1, a 59-year-old woman, underwent a jejunectomy for adhesive ileus after operation for gastric cancer and renal tumor. An ileus tube was indwelt until 6th hospital day as a splint. The patient developed ileus condition early after removal of the tube. The patient was diagnosed as having recurrence of ileus and was operated on. At laparotomy, we confirmed three intussusceptions, two in the jejunum and one in the ileum, which were reduced by means of maneuver. Patient 2, a 72-year-old man, underwent a resection of the intestine for adhesive ileus after traumatic rupture of the small intestine. During indwelling an ileus tube for the purpose of splint, ileus recurred on the 3rd hospital day. CT scan offered a suspicion of intussusception and the patient was operated on. Upon laparotomy, it was revealed that the upper part of the jejunum invaginated, and a jejunectomy was performed. Both cases were thought to be of intussusception due to ileus tube for splint. Out of 24 cases seen in the Japanese literature, nine (38%) cases of intussusception were caused by ileus tube for the purpose of splint after operation which mostly developed early after removal of the tube. In the case of usage of ileus tube to prevent postoperative ileus, careful observation of the clinical course would be mandatory considering a possible association of the disease.