The Importance of Abdominal Pain in the Elderly: An Unlikely Diagnosis of 17 cm Colo-Colonic Intussusception

We report an interesting case of a 17 cm colo-colonic intussusception involving the transverse colon, caecum, and distal small bowel in a previously healthy 79-year-old man. The patient presented to the emergency department with a two-day history of mild, left to right iliac fossa abdominal pain, with no other concerning symptoms. He had a CT of the abdomen and pelvis with contrast for suspected subacute bowel obstruction secondary to recurrent bowel cancer. This was reported as colo-colonic intussusception. Following a surgical review, he was transferred from the local district general hospital for an exploratory laparotomy and underwent a right hemicolectomy with primary ileocolonic anastomosis the same evening. The patient was discharged seven days later following an unremarkable post-operative recovery. Final histology confirmed a mucinous adenocarcinoma of the caecum with postoperative cancer staging as T2N0M0. Following discussion at the colorectal multidisciplinary meeting, no adjuvant therapy was advised, and he was placed on the standard colorectal cancer surveillance program for the next five years.