Sigmoidorectal intussusception of adenoma of sigmoid colon treated by laparoscopic anterior resection after sponge-on-the-stick-assisted manual reduction.

Department of Surgery, Dong-A University College of Medicine, 3-1 Dongdaeshin-Dong, Seo-Gu, Pusan 602-714, South Korea.
World Journal of Gastroenterology (Impact Factor: 2.43). 02/2006; 12(1):146-9.
Source: PubMed

ABSTRACT We present herein a case report of sigmoidorectal intussusception as an unusual case of sigmoid adenomatous polyp. The patient was a 56-year-old man who suffered from rectal bleeding for one day. He initially visited his general practitioner and was diagnosed as having an intraluminal mass of 15 cm from the anal verge. Several hours after admission to our coloproctology clinic, he suddenly presented with lower abdominal cramping pain with rectal bleeding during his bowel preparation using polyethylene glycol electrolyte solution. An emergency colonoscopy revealed that the invaginated colon with polypoid mass was protruded to the lower rectum. Gastrograffin enema showed that the invaginated bowel segment was 3 cm from the anal verge. CT scan showed the typical finding of intussusception. We performed laparoscopic anterior resection and anastomosis after the sponge-on-the-stick-assisted manual reduction. The permanent pathologic finding showed villotubular adenoma of the sigmoid colon.


Available from: Ki Jae Park, Jan 27, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Intussusception in adults is a rare phenomenon involving the colon in approximately 20% of cases. A 65-year-old man was hospitalized with anorexia, anemia, dehydration, and melena. Digital rectal examination revealed a palpable mass approximately 5 cm from the anal verge. The mass moved between the rectosigmoid colon and the rectum below the peritoneal reflection during radiographic examinations and during sigmoidoscopy. We strongly suspected a rectosigmoid pedunculated tumor and performed a low anterior resection. Intraoperatively we observed intussusception of the rectosigmoid colon with easy manual reduction. The tumor was palpable in the rectosigmoid colon. The postoperative course was uneventful. This case illustrates intussusception of a rectosigmoid type 1 colon adenocarcinoma mimicking a pedunculated tumor.
    05/2014; 2014:696403. DOI:10.1155/2014/696403
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 66-year-old woman presented with 3-month history of progressive constipation and occasional bright red per-rectal bleeding. An urgent flexible sigmoidoscopy (FS) showed an abnormal lesion within the anal canal and biopsy showed tubulovillous adenoma with low-grade dysplasia. She mentioned "no" response to a preparatory enema given before FS. The patient presented 4 days after FS with absolute constipation and passing a "jelly-like" substance since the procedure. A large soft tissue lump with "currant jelly" mucus discharge was noted on per-rectal examination. An abdominal x ray was suggestive of distal large bowel obstruction and a water-soluble contrast enema suggested sigmoidorectal intussusception. The intussusception was irreducible with rigid sigmoidocopy and therefore the patient underwent sigmoid resection and Hartmann's procedure, which showed a distal sigmoid polyp as a lead point for the intussusception. Retrospectively looking into the case, the intussusception was present during FS, but was scoped-around and therefore lesion was considered to be in the anal canal.
    Case Reports 06/2009; 2009. DOI:10.1136/bcr.01.2009.1532
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Adult intussusception is a different disease from that encountered in children with a higher rate of pathological lead points, the majority of which in the colon are malignant. This has supported a practice of mandatory laparotomy and en bloc resection without reduction for colonic adult intussusception. We report three cases of adult colonic intussusception, which demonstrate a variety of presenting features and discuss the investigation and treatment of this uncommon condition.