A Case of Intussusception Prolapsing through the Anus Caused by Sigmoid Colon Cancer Diagnosed by Intraoperative Colonoscopy

KUNIYASU, Marina; YOSHIDA, Michihiko; Mizumoto, Toru; Hirata, Kenro; Tsujimura, Takuya; Ueno, Koji

doi:10.3919/jjsa.82.1401

Cited by 1 publication

(1 citation statement)

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“…Some researchers have reported that preoperative reduction was important to determine the appropriate extent of bowel resection and lymph node dissection before performing oncological resection. In addition, it could improve intestinal edema and increase the possibility of avoiding a colostomy ( 15 ). In our both cases, preoperative reduction was attempted but failed.…”

Section: Discussionmentioning

confidence: 99%

Two cases of sigmoid colon cancer with intussusception prolapsing through the anus in adults: consideration of preoperative reduction and surgical approaches: case reports

Doita,

Taniguchi,

Ogawa

et al. 2024

AME Case Rep

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Background Adult intussusception is a rare condition that is often associated with a high incidence of malignancy. The optimal management strategy remains controversial, particularly regarding the necessity for bowel reduction before resection. To date, there is a paucity of data on adult intussusception in the English literature. We present two cases of sigmoid colon cancer with intussusception prolapsing through the anus and highlight the different surgical approaches. Case Description Case 1: an 84-year-old woman presented with sigmoid colon prolapse and biopsy-confirmed adenocarcinoma. Urgent surgery revealed intussusception. Despite unsuccessful manual reduction, the Hutchinson technique successfully resolved the intussusception. Resection with a temporary colostomy was performed. Histopathological examination revealed mucinous adenocarcinoma without metastasis; the patient recovered well. Case 2: a 76-year-old woman with sigmoid colon prolapse presented with abdominal pain and blood-streaked stools. Emergency surgery was performed because of failed reduction attempts and persistent symptoms. Intussusception resolution was achieved through transanal insertion of a circular sizer. Resection with temporary colostomy was performed, after which tubular adenocarcinoma was identified. The patient remains symptom-free 3 years post-surgery. Conclusions Choice of the surgical approach depends on the ease of intussusception reduction. In cases wherein reduction is straightforward, routine preoperative examinations are preferred given the low risk of injury or cancer cell dissemination. Conversely, in situations such as ours, gentle reduction under general anesthesia might be crucial. In addition, laparoscopic surgery could be beneficial. Importantly, accumulation of reports on adult intussusception could contribute to the standardization of this approach.

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Section: Discussionmentioning

confidence: 99%