Kanwardeep Singh, MBBS, Joseph G. Gabriel, MD, Nimrat Bains, MD, Mark F. Young, MD
East Tennessee State University, Johnson City, TN
Introduction: We report a case of colo-colic intussusception caused by sigmoid adenocarcinoma with concomitant incidental entero-enteric intussusception in a middle aged female. Intussusception in adults is a known rarity, but it is important to note that more than 60% of large bowel intussusceptions are caused by a neoplasm.
Case Description/Methods: A 50 year old female presented with intermittent abdominal pain for 2 months, worsening with oral intake and associated with abdominal distension and obstipation. Computed tomography of the abdomen & pelvis showed two areas of intussuscepted bowel in the left upper quadrant. One was thought to be an incidental loop of the jejunum. The other representing the splenic flexure and was causing obstruction within the small and large bowel proximal to this lesion. With the diagnosis of intussusception, exploratory laparotomy was performed. A mass was palpated at the splenic flexure, and this was found to originate at the sigmoid colon, leading to left hemicolectomy and
transverse colostomy. The histological diagnosis of the mass was well-differentiated adenocarcinoma stage IIIb. The patient later underwent adjuvant chemotherapy with Capecitabine plus Oxaliplatin.
Discussion: Large bowel intussusception can be due to benign, malignant, or idiopathic etiologies. As the incidence of intussusception in adults is low, surgical exploration is imperative.
Citation: Kanwardeep Singh, MBBS, Joseph G. Gabriel, MD, Nimrat Bains, MD, Mark F. Young, MD. P1067 - DOUBLE INTUSSUSCEPTION DECEPTION. Program No. P1067. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.