A case of a colo-colic intussusception secondary to adenocarcinoma of the sigmoid colon

Authors

  • Aishwarya Bhalerao Department of Surgical Gastroenterology and GI oncology, Indraprastha Apollo Hospital, New Delhi, India
  • Supreet Kumar Department of Surgical Gastroenterology and GI oncology, Indraprastha Apollo Hospital, New Delhi, India
  • Suryalok Pratap Shah Department of Surgical Gastroenterology and GI oncology, Indraprastha Apollo Hospital, New Delhi, India
  • Alok Kumar Pandey Department of Surgical Gastroenterology and GI oncology, Indraprastha Apollo Hospital, New Delhi, India
  • Vivek Tandon Department of Surgical Gastroenterology and GI oncology, Indraprastha Apollo Hospital, New Delhi, India
  • Deepak Govil Department of Surgical Gastroenterology and GI oncology, Indraprastha Apollo Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20243563

Keywords:

Intussusception, Colo-colic intussusception, Colorectal malignancy, Lead point

Abstract

When a more proximal section of the bowel (intussusceptum) invaginates into the more distal bowel (intussuscipiens), it results in intussusception. Changes in intestinal peristalsis at the intraluminal lesion, which serves as a lead point for the intussusceptum, is assumed to be the mechanism. Adult cases of intestinal intussusception are uncommon; they make up about 1% of all bowel obstructions. We describe a case of a colo-colic intussusception caused by an adenocarcinoma of the sigmoid colon. The most frequent urgent condition in children is intussusception, although it is extremely uncommon in adults. It is challenging to make the diagnosis based only on the history and physical exam results. Since a malignant pathology typically serves as a lead point in adulthood, as opposed to childhood, treatment of this pathology still raises questions. Accurately identifying and comprehending relevant symptoms, signs, and imaging results is crucial for an adult intussusception's early diagnosis and proper treatment. It's not always obvious how to treat adult intussusception appropriately. Regarding the reduction prior to resection in sigmoido rectal intussusception cases, there is disagreement. A useful diagnostic marker of colorectal intussusception in bowel-within-bowel configuration cases is the target-like sign on CT images, which shows the bowel's layers duplicated to form concentric rings. Quick and precise diagnosis will be facilitated by a high index of suspicion combined with radiological investigation. A high degree of suspicion of a malignant etiology is important in cases of adult intussusception.

References

Panaccio P, Fiordaliso M, Testa D, Mazzola M, Battilana MR. Minimally invasive treatment of sporadic burkitt’s lymphoma causing ileocaecal invagination Hindawi. Case Report Surg. 2018;2:62-5.

Honjo H, Mike M, Kusanagi H. Adult intussusception: a retrospective review, World J. Surg. 2015;39:134–8.

Erkan N, Haciyanli M, Yildirim M. Intussusception in adults: an unusual and challenging condition for surgeons. Int J Color Dis. 2005;2:452–6.

Marsicovetere P, Ivatury S, White P. Intestinal intussusception: etiology, diagnosis, and treatment, Clin. Colon Rectal Surg. 2016;3:30–9.

Azar T, Berger DL, M. Gen M, Adult intussusception, Ann. Surg. 1997;226:134–8.

Vemuru SR, Friel CM, Hoang SC. Adenocarcinoma as the lead point leading to ColoColic intussusception. J Gastrointest. Surg. 2018;22:2177–8.

Yalamarthi S, Smit RC. Adult intussusception: case reports and review of literature. Postgrad Med J. 2005;81:174–7.

Nesbakken A, Haffner J, Colo-recto-anal intussusception. Case report, Acta Chir. Scand. 155 (1989) 201–204.

[9] A. Marinis, A. Yiallourou, L. Samanides, N. Dafnios, G. Anastasopoulos, I. Vassiliou, et al., Intussusception of the bowel in adults: a review, World J. Gastroenterol. 2009;15(4):2407–11.

DG Begos, A Sandor, IM Modlin. The diagnosis and management of adult intussusception. Am J Surg. 1997;173:88–94.

Fujii Y, Taniguchi NK. Intussusception induced by villous tumor of the colon: sonographic findings, J. Clin. Ultrasound. 2002;30:48–51.

Maldonado TS, Firoozi, Stone BD, Hiotis K. Colocolonic intussusception of a giant pseudopolyp in a patient with ulcerative colitis: a case report and review of the literature. Inflamm Bowel Dis. 2004;10(1):41-4.

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Published

2024-11-27

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Section

Case Reports