Kohga A, Kawabe A, Hasegawa Y, Yajima K, Okumura T, Yamashita K, Isogaki J, Suzuki K, Komiyama A. Ileo-ileal intussusception caused by lymphangioma of the small bowel treated by single-incision laparoscopic-assisted ileal resection. World J Gastroenterol 2017; 23(1): 167-172 [PMID: 28104992 DOI: 10.3748/wjg.v23.i1.167]
Corresponding Author of This Article
Atsushi Kohga, MD, Division of Surgery, Fujinomiya City General Hospital, 3-1, Nishiki-cho, Fujinomiya, Shizuoka 4180076, Japan. akohga11@yahoo.co.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Atsushi Kohga, Akihiro Kawabe, Yuto Hasegawa, Kiyoshige Yajima, Takuya Okumura, Kimihiro Yamashita, Jun Isogaki, Kenji Suzuki, Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Shizuoka 4180076, Japan
Akira Komiyama, Division of Pathology, Fujinomiya City General Hospital, Fujinomiya, Shizuoka 4180076, Japan
Author contributions: All authors contributed to the acquisition of data and the writing and revision of this manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of Fujinomiya City General Hospital.
Informed consent statement: This case report is provided for academic communication only, not for other purposes. In this case report, the images do not disclose the patient’s personal information. Consent was acquired from the patient for publication of this case report.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Atsushi Kohga, MD, Division of Surgery, Fujinomiya City General Hospital, 3-1, Nishiki-cho, Fujinomiya, Shizuoka 4180076, Japan. akohga11@yahoo.co.jp
Telephone: +81-54-4273151 Fax: +81-54-4237232
Received: July 27, 2016 Peer-review started: July 30, 2016 First decision: September 28, 2016 Revised: October 7, 2016 Accepted: October 30, 2016 Article in press: October 31, 2016 Published online: January 7, 2017
Abstract
Intraabdominal lymphangiomas are uncommon; additionally, those affecting the gastrointestinal tract are rare and account for less than 1% of cases. Intussusception caused by a cystic lymphangioma of the small bowel is extremely rare. The patient was a 20-year-old woman who visited our emergency room with a complaint of abdominal pain. A computed tomography image revealed ileo-ileal intussusception with a leading hypovascular mass measuring 1 cm in a diameter. Single-incision laparoscopic-assisted ileal resection was performed. The surgical specimen consisted of a soft polycystic mass. Macroscopically, a pedunculated polyp with a convolutional pattern was found. Microscopically, the inner surfaces of the cysts were covered with a single layer of endothelial cells. On immunohistochemical examination, the endothelial cells were partially positive for D2-40 and CD34. Smooth muscle cells were also found around the cysts. The lesion was diagnosed as a cystic lymphangioma. Dozens of cases of small bowel lymphangiomas have previously been reported. Of these, cases with intussusception were very rare. This is the first case of small bowel intussusception due to lymphangioma treated by single-incision laparoscopic-assisted surgery.
Core tip: We observed an extremely rare case of small bowel intussusception caused by cystic lymphangioma. Dozens of lymphangiomas of the small bowel have previously been reported. Of these, few cases with intussusception have been reported. In the present case, single-incision laparoscopic-assisted surgery was useful for treating the telescoped lesion. To our knowledge, no cases of small bowel intussusception due to lymphangioma have been treated by laparoscopic surgery.
