Abstract
Intussusception is a common cause of intestinal obstruction and colicky abdominal pain in the children, particularly infants, the commonest being the ileocolic variety with colocolic variety being a very rare entity. We present a case of colocolic intussusception in a 13-year-old boy which is otherwise seen in adults, precipitated by colonic malignancies. The patient presented with acute abdominal pain and bleeding perrectum with obstipation for 7 days. Preoperative USG abdomen was normal, and abdominal X-rays showed multiple air fluid levels. Intraoperative findings included a polypoidal growth in the descending colon as the leading point with the formation of a colo-colic intussusception. Following reduction and segmental resection, histopathology reported mucinous adenocarcinoma of colon which is also a rarity in pediatric age group. This case has been compared with previous cases reported in the literature.
Highlights
Intussusception occurs when one portion of the gut becomes invaginated within an immediately adjacent segment, almost invariably, proximal into the distal
Pediatric patients with colocolic intussusception should suggest the possibility of a colonic polyp or mass lesion [1]
Mahmudloo et al reported a case of colo-colic intussusception without a pathologic lead point in a 7-year-old boy [1], but the majority of the case reports in the literature reported juvenile polyps responsible for this variety of intussusception in the pediatric age group [2]
Summary
Intussusception occurs when one portion of the gut becomes invaginated within an immediately adjacent segment, almost invariably, proximal into the distal. Other types of intussusception that are rarer and have an anatomic lead point include ileoileal, colocolic, and ileoileocolic. Almost all cases of colocolic intussusception occur with a lead point such as polyp or tumoral mass. In a significant number of these cases, juvenile polyps were identified as leading point. Intussusception lead points are more common in neonates, older children, and cases restricted to the small intestine. Colocolic intussusception in the adults is almost always a complication of preexisting colonic disease, usually carcinoma or polypoid tumor. Pediatric patients presenting with documented colocolic intussusception should suggest the possibility of a colonic polyp or other mass lesions
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