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Sigmoidorectal intussusception in adults: a case report
M Assenza1, G Ricci, A Antoniozzi
1U.O.C. Chirurgia dUrgenza e Trauma A, Dipartimento Emergenza Accettazione, Policlinico Umberto I, La Sapienza Universiti Roma, Italia.
La Clinica Terapeutica
|April 16, 2010
Summary
Adult intussusception is rare and often requires surgery. This case highlights a tubular adenoma causing sigmoid-rectal intussusception, emphasizing the need for prompt diagnosis and surgical intervention in adults.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Imaging
Background:
- Intussusception is a common pediatric condition but rare in adults, accounting for only 5% of all cases.
- Adult intussusception frequently has an identifiable cause (70-90%) and is associated with a higher risk of malignancy (40-50%).
- Preoperative diagnosis in adults can be challenging due to the condition's rarity.
Observation:
- A 75-year-old female presented with anal bleeding and a palpable abdominal mass.
- CT scan revealed sigmoido-rectal intussusception.
- Surgical exploration identified a 1.2 cm tubular adenoma with low-grade dysplasia in the distal sigmoid colon as the cause.
Findings:
- The patient underwent successful emergency anterior resection with colo-rectal anastomosis.
- Histopathology confirmed a benign tubular adenoma, despite the initial concern for malignancy in adult intussusception.
- Postoperative recovery was uneventful, with discharge after 7 days.
Implications:
- This case underscores the importance of surgical intervention for all adult intussusception cases, regardless of initial presentation.
- Abdominal CT is crucial for accurate diagnosis of intestinal intussusception in adults.
- While benign causes exist, the significant association with malignancy necessitates thorough investigation and surgical management.
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