Abstract
BackgroundColonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass.Case presentationA 25-year-old man presented with an acute abdomen and severe crampy abdominal pain. The clinical picture mimicked acute appendicitis. Transabdominal ultrasound examination revealed a 5 cm circular mass in the right upper abdomen. The ensuing computed tomography suggested an intussusception in the ascending colon. Intraoperatively, no full thickness invagination was detected. Due to a hard, intraluminal tumor a standard right hemicolectomy with ileotransversostomy was performed. The histopathological analysis revealed a cystic colon duplication leading to mucosal invagination and obstruction.ConclusionsIn adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions. Unlike its preferentially nonsurgical management in children, a bowel intussusception in adults should be operated because an organic, often malignant lesion is present in most cases.
Highlights
Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding
Gastrointestinal duplications can manifest with signs of acute abdomen or acute bleeding, necessitating emergency surgery [2]
Case presentation A 25-year-old man presented with an acute abdomen with abdominal defence and rebound in the right lower quadrant and with severe crampy abdominal pain
Summary
Colon intussusception mostly occurs in children up to two years of age (boys to girls ratio: 3 to 1) due to intermittent changes in bowel motility. Adults with intussusception (as well as with enteric duplications) are presenting with various non-specific symptoms of bowel obstruction, like abdominal pain, nausea and constipation [1]. These symptoms can be acute, subacute or chronic. In up to 50% of colonic intussusceptions in adults, the colonic lesions are malignant (adenocarcinoma), so the definitive treatment should be oncological surgery with the resection of the affected bowel segment [7,8]. Bowel intussusceptions and gastrointestinal duplications are rare but have to be kept in mind in the differential diagnosis of an acute abdomen in adults. All authors read and approved the final version of the manuscript and agree with the manuscript's results and conclusions
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