Transient Descending Colocolonic Intussusception Due to a Large Fecaloma in an Adult

Abstract

Intussusception typically occurs in infants and children, with adults representing 5% of cases. A 53-year-old African American woman presented with lower abdominal pain and tenderness. Computed tomography of the abdomen and pelvis demonstrated a 3.5 cm colocolonic intussusception in the descending colon. Emergent colonoscopy found solid stool in the mid descending colon. Water-soluble rectal enema showed a filling defect in the mid descending colon. Repeat colonoscopy demonstrated presence of a large fecaloma in left colon. Laxatives were initiated, and abdominal pain subsided. To our knowledge, this is the first report of colocolonic intussusception secondary to fecaloma.

A Rare Case of Adult Colonic Intussusception From Benign Etiology

“…In adults, because malignancy is such a concern, this treatment option is often limited to instances of transient non-obstructive intussusception. It is estimated that 70-90% of adults with intussusception, undergo surgical resection, much like the patient we presented here [10].…”

Transient Sigmoidorectal Intussusception Simulating Submucosal Tumor in a Healthy Woman: An Unusual Case and Review of the Literature

“…It is supposed that any lesion in the bowel wall or within the lumen that modifies normal peristaltic activity is capable to initiate the process of intussusception. This theory, however, does not clarify the idiopathic cases of intussusception without any organic trigger [12].…”

“…Secondary intussusception is induced by organic lesions, including benign and malignant neoplasms, and metastatic cancers, inflammatory bowel disease, postoperative adhesions, Meckel's diverticulum, or triggered iatrogenically due to the presence of intestinal tubes or jejunostomy feeding tubes after gastric surgery. Primary or idiopathic intussusception is frequently transient, whereas secondary intussusception due to a lead point is commonly permanent or recurrent [12]. About 20% of patients have no apparent etiology and are labelled as primary or idiopathic and intussusceptions without a lead point tend to be transient, self-limiting, and nonobstructing [8,9].…”

Colonic intussusception caused by a sigmoidal lipoma: A case report

“…Although the majority of cases of intussusception occur in children, intussusception in adults represents only 5% of all cases [ 5 ]. It is the cause of adult symptomatic bowel obstruction in 1% of cases [ 1 ].…”

“…Intussusception occurs more frequently in the small bowel than in the large bowel, representing 70–80% of cases. 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 [ 5 ]. In fact, colo-colonic occurrence represents 17% of all intestinal intussusceptions in adults [ 1 ].…”