A rare case of acute idiopathic colocolic intussusception in an adult patient

Abstract

Adult intussusception is a rare condition that is frequently associated with malignancy and requires surgical approach. Symptoms are often non-specific and of subacute or chronic character. Therefore, computerized tomography (CT) scan is the most commonly used modality for identifying adult intussusception. A 51-year-old female presented with a 1-day history of increasing abdominal pain. Abdominal ultrasound and CT scan revealed intussusception. Intra-operatively, colocolic intussusception was present and laparoscopically reduced. A lead point was found neither intra-operatively nor in post-operative ileocolonoscopy and resection of involved bowel segments was not necessary.

Figure 1

Abdominal ultrasound showed a ‘pseudokidney’ sign on the longitudinal view of the lower abdomen.

Figure 2

Intravenous contrast-enhanced abdominal and pelvic CT scan showed the full extent of the colocolic intussusception. No lead point was evident. (Left) Coronar view with ‘sausage’-shaped lesion. (Middle) Axial view with ‘sausage’-shaped lesion. (Right) Sagittal view with ‘targed’-shaped lesion.

Figure 3

Intra-operative finding of the intussusception. (Left) The terminal ileum and the appendix were pulled like a tail by the intussusceptum into the intussusception. (Right) The cecum was identified as the intussusceptum, telescoping into the transverse colon that was identified as the intussuscipiens.