Abstract
Intussusception, although quite common in children with the classic triad of cramping abdominal pain, bloody diarrhea, and palpable masses, is a rare cause of acute abdomen with myriad presentations in adults. It is defined as the telescoping of a proximal segment of the gastrointestinal (GI) tract, called the intussusceptum, into the lumen of the adjacent distal segment of the GI tract, called intussuscipiens. Due to its different manifestations and time course, adult colonic intussusception often poses a diagnostic challenge for emergency doctors. The treatment of colonic intussusception in adults typically involves surgery, often with bowel resection and anastomosis followed by a defunctioning loop ileostomy. We report a case of left-sided colocolic intussusception secondary to a tubular adenoma as the lead point, which was successfully treated by resection and primary anastomosis. The pathological diagnosis of the lesion was reported as adenocarcinoma and resected bowel margins were found free of the tumor.
Highlights
Intussusception, quite common in children with the classic triad of cramping abdominal pain, bloody diarrhea, and palpable masses, is a rare cause of acute abdomen with myriad presentations in adults
The treatment of colonic intussusception in adults typically involves surgery, often with bowel resection and anastomosis followed by a defunctioning loop ileostomy
We report a case of left-sided colocolic intussusception secondary to a tubular adenoma as the lead point, which was successfully treated by resection and primary anastomosis
Summary
A 46-year-old man presented to the emergency room with complaints of multiple episodes of loose stools (15–20 episodes/day) mixed with blood and nonprojectile bilious vomiting (10–15 episodes/day) for 2 days. 20 breaths/min, oxygen saturation 98% on room air, and body temperature 98.6°F, and examination of the respiratory, cardiovascular, and central nervous systems revealed no obvious abnormality. His abdominal examination showed gross distension with apparent peristalsis and was diffusely tender with evidence of guarding on palpation. A note of dilated large bowel loops due to colocolic intussusception, present from distal transverse colon till sigmoid colon, was made on exploration of the abdomen. The final diagnosis was acute intestinal obstruction secondary to malignant left-sided colocolic intussusception
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