PMC7876920_01
preoperative CT scan. a) residual scar of cardiac surgery as a hypodense formation of 2 cm of diameter; b, c) radiological picture of small bowel obstruction with multiple air-fluid levels; the arrows indicate the previously constructed intestinal anastomoses that appeared well established; d-f) typical target sign of intussusception of a tract of 10-cm lenght ileum.
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On cardiology follow-up he had a normal cardiac function with no assumption of anticoagulants and the only surgical residue was a hypodense formation (2 cm of diameter) on chest CT (Fig. 1a). Furthermore, he had previously undergone two partial resections of the small intestine with side-to-side entero-enteric anastomosis in our department for large pleomorphic sarcoma metastases causing recurrent intussusceptions (Fig. 1b and c). Contrast-enhanced CT abdominal scan detected the typical target sign of intussusception of a tract of 10-cm lenght ileum with dilation of the proximal intestine and air-fluid levels (Fig. 1).
intraoperative findings. a) intussusception of a 15-cm section of small intestine caused by a 4-cm intraluminal mass; b) the surgical forceps indicates the site of the intraluminal neoplasm.
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Laparotomy by a small midline incision performed on the same day identified an intussusception of a 15-cm section of small intestine caused by a 4-cm intraluminal mass, about 40 cm away from Treitz ligament and distal to previous anastomosis (Fig. 2).