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. 2019 Jan 29;3(1):49-52.
doi: 10.23922/jarc.2018-021. eCollection 2019.

Laparoscopic surgery for idiopathic adult intussusception successfully reduced by colonoscopy

Mitsunobu Imasato  1   2 , Ho Min Kim  1 , Shigeyoshi Higashi  1 , Jun Kajihara  1 , Hisanori Hatano  1 , Koichi Demura  1 , Yasuhiko Iiboshi  1 , Toshikazu Ito  1
Affiliations

Laparoscopic surgery for idiopathic adult intussusception successfully reduced by colonoscopy

Mitsunobu Imasato et al. J Anus Rectum Colon. .

Abstract

Most cases of adult intussusception are caused by neoplastic lesions, and idiopathic adult intussusception is very rare. We present a case in which laparoscopic surgery was performed for idiopathic adult intussusception initially reduced by colonoscopy. A 53-year-old woman presented to the emergency department of our hospital with intermittent lower abdominal pain. Contrast-enhanced computed tomography and ultrasonography of the abdomen showed a concentric structure in the ascending colon. We diagnosed intussusception. Colonoscopy achieved successful reduction before surgery. Twelve days after this reduction, laparoscopic surgery was performed. Histopathological examination did not reveal any causative pathology; therefore, idiopathic adult intussusception was diagnosed. The postoperative course was uneventful, and the patient was discharged on postoperative day 14. Preoperative colonoscopy should be utilized to diagnose the main lesion and may be useful for reducing adult intussusception. Laparoscopic surgery is both minimally invasive and safe and can be performed following endoscopic reduction.

Keywords: endoscopic reduction; idiopathic adult intussusception; laparoscopic surgery.

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Conflict of interest statement

Conflicts of Interest There are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Abdominal ultrasonography showing a stratified structure as a pattern of multiple concentric rings.
Figure 2.
Figure 2.
Abdominal CT showing ascending colon wall thickening and invagination on the oral side of the intestine. (A) The target sign is evident in the intussusception (arrows). (B) No distinct tumor lesions are present at the lead point (arrowhead).
Figure 3.
Figure 3.
The intussusception is successfully reduced by colonoscopy with CO2 pressure. (A) Endoscopic examination showing the presence of a submucosal tumor-like lesion in the ascending colon. (B, C) The mucosa on the oral side of that lesion showing severe erosion and edema. (D) Positive cushion sign of the tumor-like lesion.
Figure 4.
Figure 4.
Resected specimen showing only mucosal erosion and mild ulcer. No tumor or malignant findings are apparent.
See this image and copyright information in PMC

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