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[Primary colonic intussusception protruding from the anus in adults. Two cases]
J P Bail1, L J Holderbach, M Robaszkiewicz
1Service de Chirurgie générale et digestive, CHRU Morvan, Brest.
Annales De Radiologie
|January 1, 1992
Summary
Adult intussusception cases protruding from the anus, termed colon-anal intussusception, were successfully treated without colostomy. These rare, non-tumor-related intussusceptions highlight alternative surgical approaches.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Colonic intussusception in adults is uncommon, often associated with a tumor.
- Colon-anal intussusception, specifically, is exceedingly rare, with fewer than twenty cases reported in adults since 1925.
- The etiology of adult intussusception is typically neoplastic, making non-neoplastic cases noteworthy.
Observation:
- Two adult patients presented with intussusception protruding from the anus (colon-anal intussusception).
- Case 1 involved chronic ileo-caeco-colic intussusception.
- Case 2 presented as acute colo-rectal intussusception.
Findings:
- Both cases were confirmed to be non-tumor-related, a rare characteristic, with only three similar cases previously documented.
- Surgical management involved primary colonic resection without the need for a colostomy in both instances.
- The first case required subtotal colectomy with ileo-rectal anastomosis, while the second case was successfully reduced via barium enema prior to surgical resection.
Implications:
- These cases demonstrate that colon-anal intussusception in adults can occur without an underlying tumor.
- Primary colonic resection without colostomy is a viable surgical strategy for non-neoplastic colon-anal intussusception.
- Barium enema can be a useful adjunct in managing acute colo-rectal intussusception, facilitating secondary surgical intervention.