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Retrograde Colonic Intussusception After Colonoscopy without Organic Pathology: A Case Report
Nobuhisa Tanioka1, Michio Kuwahara1, Takashi Sakai1
1Department of Surgery, Hata Kenmin Hospital, Sukumo, Kochi, Japan.
The American Journal of Case Reports
|October 13, 2024
Summary
This case report details a rare instance of retrograde colonic intussusception in an adult, potentially linked to colonoscopy procedures, without identifiable organic abnormalities. It suggests mechanical stress during colonoscopy may trigger this condition, offering new insights into intussusception pathogenesis.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Medical Imaging
Background:
- Adult colonic intussusception is uncommon, typically linked to organic lead points.
- The pathogenesis of adult intussusception remains incompletely understood.
- Retrograde colonic intussusception without pathological abnormalities or colonoscopy association is unreported.
Observation:
- A 74-year-old woman presented with abdominal distension and constipation.
- Initial CT suggested sigmoid volvulus; colonoscopy revealed no abnormalities.
- Persistent symptoms led to a second colonoscopy and transanal drainage, followed by worsening pain.
Findings:
- Abdominal CT revealed retrograde sigmoid colon intussusception.
- Laparoscopic left hemicolectomy was performed.
- Pathology showed ulcers but no organic lead point; colonoscopy-induced mechanical stress is hypothesized.
Implications:
- This is the first reported case of colonoscopy-associated retrograde colonic intussusception without organic abnormalities.
- The case may offer novel insights into the pathogenesis of intussusception.
- Mechanical factors during colonoscopy, such as stretching or shear stress, are implicated.
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