Adult intussusception caused by colonic anisakis: A case report

Colo-colonic intussusception is an uncommon phenomenon in an adult. Adult intussusception accounts for < 5% of total cases, and the colo-colonic type is < 30% of cases. Although surgical management has been the treatment of choice for intestinal intussusception in adults, because most frequent causes for adult intussusception are malignant in origin, the importance of the roles of preoperative colonoscopic evaluation has recently been emerging.

We report an extremely rare case of adult colo-colonic intussusception caused by colonic anisakiasis and successfully treated by endoscopic removal of the Anisakis body. A 59-year-old man visited the emergency department due to 1 day of lower abdominal colicky pain. Abdominopelvic computed tomography (APCT) revealed the presence of mid-transverse colon intussusception without definite necrosis, which was possibly related with colorectal cancer. Because there was no evidence of necrosis at the intussusception site, a colonoscopy was performed to target the colonic lesion and obtain tissue for a histopathological diagnosis. An Anisakis body was found when inspecting the suspicious colonic lesion recorded by APCT. The Anisakis body was removed with forceps assisted by colonoscopy. The patient's symptoms improved dramatically after removing the Anisakis. A reduced colon without any pathological findings was seen on the follow-up APCT. Without any further treatment, the patient was discharged 5 d after the endoscopy.

When colonic intussusception without necrosis occurs in an adult, physician should consider a colonoscopy to exclude causes cured by endoscopy.