CASE HISTORY

For three years the patient had suffered from recurring attacks of colicky abdominal pain accompanied by vomiting. She had been admitted on one or two occasions and no very positive findings were made. In November 1956 she was again in hospital with one of these attacks and now a mass was palpable in the right  iliac fossa. She was transferred to the Department of Surgery where a provisional diagnosis of intussusception was made and a laparotomy performed. She was found to have an ileal intussusception approximately 9 inches short of the ileo-caecal valve. Reduction was performed and she was then found to ave some polypoid mass within the lumen of the ileum and at the head of the intussusception. This was resected and the patient made a  good recovery.

PATHOLOGY

The specimen consists of a loop of distal ileum with a tumour in the middle. Externally there is very considerable injection of the vessels of the intestine and its mesentery. The wall of the intestine is thickened by oedema. In addition, there appears to be some actual muscular hypertrophy as well, a dark line corresponding to the muscle being clearly visible. In the middle of the specimen and attached to the wall on the anti-mesenteric side there is an ovoid tumour; the central part is pale grey with numerous red spots in it; the surface is ulcerated and reddened; this has been caught in the intestine and been pushed in an upward direction.