An unusual case of colonic intussusception in old age

Abstract

Intussusception refers to the telescoping of a bowel segment into the lumen of an adjacent distal bowel. It is a rare entity and an uncommon cause of intestinal obstruction in adults. Approximately 90% of cases of intussusception in adults have an organic cause as a lead point. Usually, the patient presents with signs of acute abdomen with a short history. Although it is difficult to diagnose colonic intussusception clinically, medical imaging by ultrasonography and computed tomography can easily detect this rare but clinically important disease. This case report describes an uncommon location of intussusception in the colon in a 70-year-old female patient.

Keywords: Computed tomography; Elderly patient; Intussusception; Ultrasound imaging.

Figure 1

a) Longitudinal and b) transverse ultrasonography images of a 70-year-old female patient showing the pseudo kidney sign and the target sign of bowel intussusception, respectively.

Figure 2

Axial CT images of the abdomen of the same patient with intravenous and oral contrast a) demonstrate the “sausage sign” of intussusception in the left iliac fossa, b) demonstrate the “target sign” of intussusception formed by concentric layers, including hypodense and hyperdense tissues, and c) reveal an ovoid, well-defined, hypodense mass of 7 × 5 cm inside the sigmoid colon. The attenuation coefficient of the mass was compatible with adipose tissue (lipoma).