A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception

Abstract

Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology.How to cite this articleSertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

3D Laparoscopy-Assisted Operation to Adult Intussusceptions During Perioperative Period of Liver Transplantation: Case Report and Literature Review

“…Conversely, malignant or benign tumors are still major points leading to adult intussusception, the morbidity of which is up to 50–70% reported in a meta-analysis and a review ( 3 , 9 ). Also diverticulum, inflammatory bowel disease, and so on, occasionally have been mentioned in sporadic research studies ( 10 , 11 ). Certainly, early post-operative intestinal occlusions could be relatively easy to identify, but the causes are multifactorial and ambiguous, which might be linked with primary surgical stress response, intraoperative iatrogenic mechanism, prolonged placement of abdominal drainages due to immunological response and inflammatory stimuli leading to edema of intestinal wall and exudation, electrolyte imbalance, and perioperative transfusion, etc.…”

“…Abdominal CT has been actually considered to investigate the condition in similar cases. The characteristic signs of abdominal CT referred to intussusception in adults could be detected as “target-like” or “concentric double ring” on the transverse section or “sausage-shaped” on the coronal section based on a layer effect ( 1 , 10 , 17 ). The former has also been observed in the case.…”

Recurrent colonic intussusception due to a lipoma of the transverse colon at the background of congenital dolichocolon and chronic constipation

“…We performed right hemicolectomy because of ascending colon was dilated, presented signs of dolichocolon, large size of tumour, presence of intussusception, chronic constipation 5. Many authors hold the opinion about necessity of resection due to colonic intussusception especially in older patients associated with high incidence of malignancy 1 2 6 11. Colonic lipoma may also lead to severe bleeding in case of mucosal erosion 1…”

Intussusception in the Setting of an Ulcerative Colitis Flare

“…Intussusception is a very rare cause of acute abdomen in adults and has been defined as the telescoping of a bowel segment into the lumen of an adjacent segment [ 1 , 2 ]. In patients with ulcerative colitis (UC), only seven cases of concurrent intussusception have been reported in the literature [ 2 – 8 ].…”