Synchronous adenocarcinomas of the colon presenting as synchronous colocolic intussusceptions in an adult

Chuang-Wei Chen,Koung-Hong Hsiao,Chieh-Wen Lai

doi:10.1186/1477-7819-10-272

Chuang-Wei Chen, Koung-Hong Hsiao + Show 1 more

Open Access

https://doi.org/10.1186/1477-7819-10-272

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Abstract

Intussusception is uncommon in adults. To our knowledge, synchronous colocolic intussusceptions have never been reported in the literature. Here we described the case of a 59-year-old female of synchronous colocolic intussusceptions presenting as acute abdomen that was diagnosed by CT preoperatively. Laparotomy with radical right hemicolectomy and sigmoidectomy was undertaken without reduction of the invagination due to a significant risk of associated malignancy. The final diagnosis was synchronous adenocarcinoma of proximal transverse colon and sigmoid colon without lymph nodes or distant metastasis. The patient had an uneventful recovery. The case also emphasizes the importance of thorough exploration during surgery for bowel invagination since synchronous events may occur.

Highlights

Intussusception accounts for only 1 to 5% of intestinal obstructions in adults [1]
Malignant intussusceptions account for the majority of colonic invaginations, whereas 80% of neoplasms associated with small bowel intussusception were benign [2]
Due to the high malignancy rate, en bloc resection without reduction for adult colonic intussusception is advocated to prevent any potential spread of the tumor and contamination of the abdominal cavity due to incidental perforation [8,9]

Summary

Background

Intussusception accounts for only 1 to 5% of intestinal obstructions in adults [1]. Intussusception occurs most commonly in the small bowel, and colonic intussusception accounts for 15 to 27% of its occurrence [2,3,4]. Case presentation A 59-year-old woman presented with an eight-hour history of progressive abdominal pain and vomiting. She had occasionally experienced abdominal pain, diarrhea, and rectal bleeding over the past 2 years. Her past medical history included hysterectomy due to uterine myoma for 10 years. She was alert and appeared to be in moderate distress. Her vital signs were stable and her temperature was 37.2°C. On physical examination, her abdomen was soft but moderately tender to palpation. No recurrent symptoms or signs were noted at follow-up after 12 months

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Discussion

Conclusions