Ileo-ileal intussusception caused by lymphangioma of the small bowel treated by single-incision laparoscopic-assisted ileal resection

World J Gastroenterol. 2017 Jan 7;23(1):167-172. doi: 10.3748/wjg.v23.i1.167.

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.

Keywords: Intussusception; Lymphangioma; Single-incision laparoscopic-assisted surgery.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Antibodies, Monoclonal, Murine-Derived / metabolism
  • Antigens, CD34 / metabolism
  • Cysts / complications*
  • Cysts / diagnosis
  • Cysts / pathology
  • Cysts / surgery
  • Female
  • Humans
  • Ileal Diseases / diagnosis
  • Ileal Diseases / etiology
  • Ileal Diseases / surgery*
  • Ileal Neoplasms / complications*
  • Ileal Neoplasms / diagnosis
  • Ileal Neoplasms / pathology
  • Ileal Neoplasms / surgery
  • Immunohistochemistry
  • Intussusception / diagnosis
  • Intussusception / etiology
  • Intussusception / surgery*
  • Laparoscopy / methods*
  • Lymphangioma / complications*
  • Lymphangioma / diagnosis
  • Lymphangioma / pathology
  • Lymphangioma / surgery
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD34
  • monoclonal antibody D2-40