A CASE OF RETROGRADE INTUSSUSCEPTION DUE TO A POLYP OF SIGMOID COLON IN ADULT

Abstract

This paper describes our recent experience with a case of a retrograde intussusception due to a sigmoid polyp in light of the related literature. The patient was a 72-year-old woman who was admitted to our hospital because of abdominal pain and fullness. Abdominal X-ray showed the air-fluid level and a tumor-like mass in the gas contour of the intestine. Barium enema examination showed shortening of the sigmoid colon and tapering and obstruction of the descending colon. Judging from above information, we diagnosed mechanical obstruction of the descending colon due to malignant lesion, and laparotomy was immediately performed. The tumor was palpated in the splenic flexure of the descending colon, and it was clear that the sigmoid colon invatinated into the descending colon retrogradely. We could not rule out the existense of malignant tumor at the top of the intussusceptum, so the colon, from the splenic flexure of the descending colon to the upper half of the sigmoid colon, was resected with reginal lymphmodes. The resected specimen showed a large-sized polyp (10.0×5.5×1.0cm) at the top of the intussusceptum. Microscopic examination clarified that the polyp was a tubulovillous adenoma with malignant change. Because almost all intussusception in adults is due to organic lesions, the resection of intussuscepted lesions with lesional lymphmodes should be performed without reposition, if malignancy has not been ruled out.