成人にみられた回盲部腸重積症の3例

Three Cases of Ileocecal Intussusception in the Adult

　腸重積症は臨床上稀な疾患ではないが，その多くは小児に発生し，しかも全体の75％は2歳以下の年齢層で占められている．これに反して成人における発生頻度はかなり低いといわれている．

　臨床症状として小児の場合は特徴ある症候（嘔吐，腫瘤触知，仙痛）を呈することにより本症を疑わしめることが多いが，成人の場合はかなり非典型的な経過をとるため両者の間には臨床的にかなりニュアンスが違っているように思われる．

　Intussusception is defined as invagination or telescoping of one part of the intestine into adjacent portion. This is observed most commonly in young children and shows in the majority of cases no demonstrable underlying pathology which may predispose them to it. Intussusception in the adult, as is generally accepted, usually occurs secondarily to preexisting pathology of some sort-polyp, carcinoma, diverticulurn or inflammatory process such as gastroenteritis or regional ileitis.

　While a classic case of intussusception in infants and children is easy to recognize, its clinical manifestation in the adult is a little different, particularly in cases of early or minimal stage of ileocecal intussusception; it will not always produce a definite picture of intestinal obstruction and characteristic x-ray patterns.

　The authors recently encountered 3 cases of ileocecal intussusception in the adult diagnosed by barium meal examination.

　Case No.1. A 69-year-old female with epigastric pain

　Case No.2. A 40-year-old female with upper abdominal pain

　Case No.3. 53-year-old female with lower abdominal pain

　The authors have noted a tendency toward spasm and slight dilatation in the terminal ileum. On systematic x-ray examination of the intestine, shortening of the cecum or ascending colon was detected, in which a sausagelike or mushroom-shaped filling defect was present.