Surprising Complication of Intussusception after Colonoscopy: A Case Report and A Review of the Literature

Abstract

This study discusses a case with a history of ileal-caecal intussusception post colonoscopy requiring urgent surgical intervention and a systematic review explores the literature on post-colonoscopy intussusception. A systematic review was conducted according to PRISMA guidelines. Studies reporting entero-enteric, ileo-colic, or colo-colic intussusception after colonoscopy, published in English before June 2023, were included. Data was extracted on patient demographics, indications for colonoscopy, procedural details, clinical symptoms, and management. Overall, 19 cases were identified from 17 studies. The median age was 48 years and 53 % were male. History of abdominal surgery was reported in 42% of cases. Symptoms typically appeared within a week of the procedure. The majority of cases required surgical intervention (63%), while others were managed conservatively (34%). The case report is an 85-year-old man with a history of diabetes, cardiopathy and abdominal surgery presented to the Emergency Department with 2 days of abdominal pain and vomiting after colonoscopy. A Computer Tomography abdomen revealed findings concerning for a small-bowel volvulus. Subsequent laparotomy revealed ileo-caecal intussusception, requiring surgical resection. Histology examination revealed a small-bowel intramucosal adenocarcinoma. The patient recovered and was discharged on postoperative day 7. The etiology of post-colonoscopy intussusception is multifactorial, with potential contributing factors including adhesions, altered bowel motility, and gas insufflation. Patients with a history of abdominal surgery should be considered at increased risk and prompt identification is crucial to reduce morbidity and mortality.