Intussusception during enteral nutrition: a case report

We report a case of intussusception during enteral nutrition after esophagectomy. The case was a 60-year-old patient who underwent subtotal esophagectomy via the right thoraco-abdominal approach, reconstructed with esophagogastrostomy. He underwent tube feeding through gastrostomy after surgery. The tip of the feeding tube was emplaced in the jejunum. He complained of intermittent abdominal pain and the drainage volume through the gastric decompression tube was increased on the 2nd week from surgery. There was no abnormal finding on abdominal CT or or radiography of the digestive tract, and so a diagnosis of intussusception was made and laparotomy was performed. There was descending intussusception with the jejunum where the feeding tube was emplaced. Enterectomy was not necessary in this case. Adult intussusception is rare. The surgery is sometimes the cause for intussusception. Another cause is use of a long intestinal tube. Since enteral nutrition has priority for nutritional support after esophagectomy, it is important to make an early decision whether surgical intervention is required or not, using abdominal examination by CT, ultrasound and contrast radiography, when bowel obstruction occurs during enteral nutrition through a feeding tube.