Descending colo-colonic intussusception secondary to signet ring cell carcinoma: A case report

Abstract

The incidence of intussusception is low in adults, particularly in the descending colon, due to the anatomical attachment of the descending colon to the retroperitoneum. Signet ring cell histology represents ~1% of colon adenocarcinomas and is associated with young patients and a poor clinical outcome. The present study describes a case of descending colo-colonic intussusception caused by signet ring cell carcinoma in a 27-year-old male. The patient presented with a history of intermittent left upper-quadrant abdominal pain for more than six months without any evident etiology. A computed tomography scan of the abdomen revealed left-sided colo-colonic intussusception. Upon laparotomy, a left hemicolectomy was performed according to intraoperative frozen-section pathology. Post-operative pathological evaluation revealed signet ring cell carcinoma invasion of the serosa, and 31.8% (7/22) of the regional lymph nodes were positive for cancerous cells. The post-operative course was uneventful and the patient was discharged on the tenth post-operative day.

Erythromycin triggers intussusception in a pediatric patient with Henoch–Schönlein purpura

“…It is less common in older children. Third, the colo-colonic intussusception is often accompanied with intestinal organic disease, such as rotavirus enteritis and colon carcinoma (4,5). However, no organic intestinal disease was founded in our patient.…”

Ileocecal Intussusception in an Adult Secondary to a Colon Adenocarcinoma: A Case Report and Literature Review

“…Any bowel alteration that leads to a change in normal peristalsis pattern increases an intussusception risk. Based on location and guiding point to its development, intussusception may be classified in enteric (limited to small bowel segment), ileocolic (from ileum to colon), colonic (colon to colon) and ileocecal (ileum and cecum to ascending colon); this last type was presented by our patient secondary to a cecum tumor [1,5]. Most colon intussusceptions occur in flexible segments like sigmoid, transverse colon and cecum since both ascending and descending colon are attached to retroperitoneum [5,9,12,13].…”

“…Based on location and guiding point to its development, intussusception may be classified in enteric (limited to small bowel segment), ileocolic (from ileum to colon), colonic (colon to colon) and ileocecal (ileum and cecum to ascending colon); this last type was presented by our patient secondary to a cecum tumor [1,5]. Most colon intussusceptions occur in flexible segments like sigmoid, transverse colon and cecum since both ascending and descending colon are attached to retroperitoneum [5,9,12,13]. During our search, we found that most cases of colon tumors with intussusception were reported in the rectosigmoid colon, and only two cases were reported in the right colon, mainly at the cecum [8].…”

“…Although intussusception was first described by Paul Barbette as a proximal bowel invagination to a distal portion, it was John Hunter who coined the term "intussusception" in 1789 by describing three patients with such findings [1]. Presently it is defined as telescoping of a proximal segment of the gastrointestinal tract into a distal segment and it occurs when an organic lesion of the bowel functions as a guiding point and it is pulled towards a distal segment due to normal peristalsis [2][3][4][5].…”

“…It is rare in adults, and it represents only 5% of all intussusceptions and 1-5% of all bowel obstruction cases [1,2,[4][5][6][7][8][9][10][11][12]. Unlike pediatric patients in whom it is generally idiopathic, in adults, over 90% are due to an established pathology [1,7,8].…”