Multislice CT in adult colocolic intussusception: case report and review of the literature

Abstract

Intussusception in adults is generally a rare diagnosis and generally different from intussusception in children in terms of clinical presentation, etiology, and incidence (Begos et al., Am J Surg, 173:88-94, 1997; Watson and Bisset, Clin Radiol, 49:723-726, 1994; Felix et al., Am J Surg, 131:723-726, 1976). One third of these affect the large bowel. Adult intussusception shows clinically uncharacteristic symptoms of bowel obstruction; thus, the diagnosis is often clinically missed. We report the case of a 39-year-old woman suffering from long-term abdominal pain. This case report discusses the clinical advantages of multislice computed tomography for the diagnosis of adult intussusception and shows a comprehensive overview of the literature.

Acute gastroesophageal intussusception in a patient with pneumomediastinum, pneumoperitoneum, and extensive subcutaneous emphysema resulting from iatrogenic colonic perforation

“…MDCT allows thinner collimation and enables the acquisition of highresolution volume data sets. Multiplanar reconstruction is readily performed and facilitates diagnosis (5,7). Iterative multiplanar reconstruction images in our case showed the stomach telescoping into the distal esophagus, confirming the presence of gastroesophageal intussusception.…”

“…The term intussusception defines a condition in which a bowel segment (intussusceptum) folds into an adjacent segment (intussuscipiens) (4). Intussusception primarily occurs in the small bowel and colon (2,4,5). Intussusception in the lower intestine is usually diagnosed with ultrasonography and CT (4,5).…”

Intermittent adult ileocecal intussusception: a case report and review of literature

“…12 Magnetic resonance imaging with a reported diagnostic accuracy of 96% is an alternative for computed tomography and can show nearly the same features seen on CT imaging. 14,15 The diagnosis in our case was made using abdominal ultrasound, demonstrating its usefulness in a clinically stable, non-obese patient without signs of complete bowel obstruction and with a palpable intussusception.…”

Adult colonic intussusception: Surgery still the best option

“…Colonic involvement represents up to 50% of cases, and in 70% the underlying cause is a malignant neoplasm (3). A wide range of other causes in the colon have been described including adenomatous polyps, inflammatory bowel disease, mycobacterial infection, and surgical anastomoses (4). …”

“…Abdominal and pelvic computed tomography (CT) is the preferred test of choice with the advantage of detection of lead points and accurate localisation of the lesion (3,4). The findings are often pathognomonic and include a sausage shaped soft tissue mass with an eccentric fat density ring contained within, representing mesenteric fat.…”