Transient Descending Colocolonic Intussusception Due to a Large Fecaloma in an Adult

Abstract

Intussusception typically occurs in infants and children, with adults representing 5% of cases. A 53-year-old African American woman presented with lower abdominal pain and tenderness. Computed tomography of the abdomen and pelvis demonstrated a 3.5 cm colocolonic intussusception in the descending colon. Emergent colonoscopy found solid stool in the mid descending colon. Water-soluble rectal enema showed a filling defect in the mid descending colon. Repeat colonoscopy demonstrated presence of a large fecaloma in left colon. Laxatives were initiated, and abdominal pain subsided. To our knowledge, this is the first report of colocolonic intussusception secondary to fecaloma.

Figure 1

(A) Axial abdominal/pelvic computed tomography (CT) with intravenous contrast depicting 3.5-cm colocolonic intussusception in the descending colon. (B) Frontal abdominal/pelvic CT demonstrating colocolonic intussusception in the descending colon extending over 3.5 cm.

Figure 2

Water-soluble contrast enema showing a filling defect in the distal descending colon with additional filling defects seen proximally.

Figure 3

Colonoscopy showing (A) a large fecaloma in left descending colon and (B) a large, right-sided diverticulum proximal to the hepatic flexure.