Annals of Coloproctology

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Original Article

Malignant disease,Colorectal cancer,Epidemiology & etiology

Clinicopathologic characteristics of early-onset colorectal cancer: Kui Seon Park, Young Ki Hong, Yoon Jung Choi, Jung Gu Kang; Ann Coloproctol. 2022;38(5):362-369. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00976.0139

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Purpose
The aim of this study was to analysis of the clinicopathological characteristics and prognosis of colorectal cancer (CRC) under the age of 50 years.
Methods
Between January 2009 and December 2018, 1,126 primary CRC patients were included from National Health Insurance Service Ilsan Hospital. The patients were divided into group 1 (n=111, ≤50 years) and group 2 (n=1,015, >50 years). The clinicopathologic features and prognostic outcomes were compared. In addition, to analyze whether there were any differences of those characteristics in 3 groups, patients aged under 50 years were divided into their 20s, 30s, and 40s.
Results
Group 1 had a slightly higher distribution in the left colon and rectum, lower T stage I and higher T stage IV rate, and a significantly higher distribution in stage N2 than group 2 (30.6%:16.3%, P<0.001). Poor histological differentiation of tumors was significantly high in group 1 (P=0.003). The 5-year survival rate for those in their 30s (69.2%) and 40s (91.6%) was higher than those in their 20s who died immediately after surgery (P<0.001). The 5-year disease-free survival rate was also confirmed to be meaningful for each age group, with 0% in their 20s, 53.8% in their 30s, 79.2% in their 40s (P<0.001).
Conclusion
Although the age was not an independent prognostic factor for overall survival in this study, the early onset group of CRCs is more advanced at the time of diagnosis and has a more aggressive histologic type.

Citations

Citations to this article as recorded by

Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer
Vlad Alexandru Ionescu, Gina Gheorghe, Ioana-Alexandra Baban, Alexandru Barbu, Teodor Florin Georgescu, Loredana-Crista Tiuca, Ninel Antonie Iacobus, Camelia Cristina Diaconu
Medicina.2025; 61(3): 390. CrossRef
Comparative Analysis of Tumor Characteristics, Treatment Response, and Oncological Outcomes in Early-Onset Versus Late-Onset Colorectal Cancer: A Retrospective Cohort Study
Muhammad S Khan, Azwa Ali, Murk Niaz, Raheena Hassan, Bushra Shirazi, Raja Taha Yaseen Khan
Cureus.2025;[Epub] CrossRef
Colorectal Neoplasia in Vietnamese Patients Under 50 Years of Age: A Cross-Sectional Study
Nhan Quang Le, Luan Minh Dang, Tien Manh Huynh, Chuong Dinh Nguyen, Diem Thi Ngoc Vo, Truc Le Thanh Tran, Vy Ly Thao Tran, An Duc Le, Tai Duy Nguyen, Hen Van Dao, Trung Duc Nguyen, Duc Trong Quach
The Korean Journal of Gastroenterology.2025; 85(2): 185. CrossRef
Comparative analysis of sporadic, IBD-associated, early-onset and late-onset colorectal cancer: a systematic review and meta-analysis
Giacomo Fuschillo, Olga Maria Nardone, Giulio Calabrese, Marc Martí-Gallostra, Francesco Selvaggi, Eloy Espín-Basany, Gianluca Pellino, Jose Perea
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Elastic Tissue Staining Significantly Enhances Detection of Venous Invasion Compared to Conventional H and E Staining in Colorectal, Breast and Thyroid Carcinomas
Afraa Asif, Yusra Khan, Manahel Khuram, Mohammed Khalil, Sunil Bylappa, Abid Shaheer
Biomedical and Pharmacology Journal.2025; 18(3): 2434. CrossRef
Short-term surgical outcomes for colon adenocarcinoma: Racial-Ethnic comparisons in a universal access health system
Yvonne L. Eaglehouse, Sarah Darmon, Michele M. Gage, Craig D. Shriver, Kangmin Zhu
Surgical Oncology.2025; 63: 102295. CrossRef
Young-onset versus late-onset colorectal cancer: clinicopathological features and survival outcome: a decade-long analysis from a middle Eastern tertiary center
Ammar Aleter, Ali Toffaha, Ejaz Ahmed Latif, Mahwish Khawar, Ibrahim Amer, Samer A. Hasan, Mahmood AL-Dhaheri, Ayman Ahmed, Ayman El-Menyar, Mohamed Abu Nada, Amjad Parvaiz
World Journal of Surgical Oncology.2025;[Epub] CrossRef
Short-term surgical outcomes in patients with early- versus average-onset colon adenocarcinoma in the Military Health System
Yvonne L Eaglehouse, Sarah Darmon, Robert W Krell, Michele M Gage, Craig D Shriver, Kangmin Zhu
JNCI Cancer Spectrum.2025;[Epub] CrossRef
Multiethnic Trends in Early Onset Colorectal Cancer
Michelle Nagata, Kohei Miyagi, Brenda Y. Hernandez, Scott K. Kuwada
Cancers.2024; 16(2): 398. CrossRef
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2024; 110(1): 45. CrossRef
Surgical and survival outcomes of early‐onset colorectal cancer patients: a single‐centre descriptive Australian study
Celine Garrett, Daniel Steffens, Michael Solomon, Cherry Koh
ANZ Journal of Surgery.2024; 94(9): 1584. CrossRef
Global epidemiology of early‐onset upper gastrointestinal cancer: trend from the Global Burden of Disease Study 2019
Pojsakorn Danpanichkul, Thanida Auttapracha, Siwanart Kongarin, Ben Ponvilawan, Daniel M. Simadibrata, Kwanjit Duangsonk, Supitchaya Jaruvattanadilok, Sakditad Saowapa, Kanokphong Suparan, Rashid N. Lui, Suthat Liangpunsakul, Michael B. Wallace, Karn Wija
Journal of Gastroenterology and Hepatology.2024; 39(9): 1856. CrossRef
Early onset metastatic colorectal cancer in Australia
A. Jalali, S. Smith, G. Kim, H. Wong, M. Lee, J. Yeung, M. Loft, R. Wong, J.D. Shapiro, S. Kosmider, J. Tie, S. Ananda, B. Ma, M. Burge, R. Jennens, B. Lee, J. Johns, L. Lim, A. Dean, L. Nott, P. Gibbs
Cancer Treatment and Research Communications.2024; 40: 100827. CrossRef
Five-year overall survival of early- and late-onset colorectal cancer in Medellín, Colombia: a comparative study
Álvaro Esteban Ruiz-Grajales, Juan Camilo Correa-Cote, Miguel Ángel Sánchez-Zapata, Manuela María Orozco-Puerta, Juan Felipe Baena-García, Esteban Castrillón-Martínez
Journal of Cancer Research and Clinical Oncology.2024;[Epub] CrossRef
The prognostic significance of clinicopathological characteristics in early-onset versus late-onset colorectal cancer liver metastases
Yi-Tong Li, Xiang-Yu Wang, Bo Zhang, Bao-Rui Tao, Zhen-Mei Chen, Xiao-Chen Ma, Jia-Hao Han, Chong Zhang, Rui Zhang, Jin-Hong Chen
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
Scientific Reports.2023;[Epub] CrossRef
Patients younger than 40 years with colorectal cancer have a similar prognosis to older patients
Tomoki Abe, Takeru Matsuda, Ryuichiro Sawada, Hiroshi Hasegawa, Kimihiro Yamashita, Takashi Kato, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Taro Oshikiri, Yoshihiro Kakeji
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical and pathological characteristics of early-onset colorectal cancer in South Korea
Su Bee Park, Jin Young Yoon, Min Seob Kwak, Jae Myung Cha
Saudi Journal of Gastroenterology.2023; 29(6): 358. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
Is the oncological impact of vascular invasion more important in right colon cancer?
Gyung Mo Son
Journal of Minimally Invasive Surgery.2022; 25(2): 49. CrossRef
Different Oncologic Outcomes in Early-Onset and Late-Onset Sporadic Colorectal Cancer: A Regression Analysis on 2073 Patients
Caterina Foppa, Annalisa Maroli, Sara Lauricella, Antonio Luberto, Carlotta La Raja, Francesca Bunino, Michele Carvello, Matteo Sacchi, Francesca De Lucia, Giuseppe Clerico, Marco Montorsi, Antonino Spinelli
Cancers.2022; 14(24): 6239. CrossRef

Case Reports

Salmonella enteritis: A Rare Cause of Adult Intussusception: Toan Pham, Domenic La Paglia, Meron Pitcher; Ann Coloproctol. 2017;33(5):201-203. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.201

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2 Citations

Abstract PDF

Intussusception is a relatively rare condition in the adult population and is commonly secondary to a malignant process. Eight to twenty percent of cases of adult intussusception are thought to be idiopathic. In children, infection has been proven to precipitate intussusception in the absence of any other cause. We present a rare case of intussusception in a healthy adult patient secondary to salmonella infection and discuss infection as a potential explanation for a proportion of the cases of adult intussusception that are thought to be idiopathic. We recommend testing for infective causes of intussusception in adults when more common causes, such as malignancy, have been excluded.

Citations

Citations to this article as recorded by

Point-of-Care Ultrasound May Reduce Misdiagnosis of Pediatric Intussusception
Hsiang-Ju Hsiao, Chao-Jan Wang, Chien-Chung Lee, Yi-Chen Hsin, Sze-Yuen Yau, Shih-Yen Chen, Wan-Chak Lo, Patricia-Wanping Wu, Chyi-Liang Chen, Yi-Jung Chang
Frontiers in Pediatrics.2021;[Epub] CrossRef
Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report
Kyota Tatsuta, Mayu Sakata, Kosuke Sugiyama, Toshiya Akai, Katsunori Suzuki, Yuhi Suzuki, Takafumi Kawamura, Yoshifumi Morita, Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Kiyotaka Kurachi, Hiroya Takeuchi
Surgical Case Reports.2020;[Epub] CrossRef

Late Presentation of Anal Canal Duplication in Adults: A Series of Four Rare Cases: Rezvan Mirzaei, Bahar Mahjubi, Mina Alvandipoor, Mohammad Yasin Karami; Ann Coloproctol. 2015;31(1):34-36. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.34

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10 Web of Science
11 Citations

Abstract PDF

Anal canal duplication (ACD) is a very rare condition, especially in adults. Four cases in adults are reported. In three cases, the orifice of duplication was located behind the native anus, and in one case, it was located anteriorly. In all cases, no communication between the anal canal and the tract of duplication was noted. Complete removals of the duplications were done through a perineal approach. Histology showed fibro-muscular tissue lined with a squamous epithelium. The postoperative courses were uneventful.

Citations

Citations to this article as recorded by

Anal canal duplication with heterotopic gastric mucosa and anal stenosis: first case report and literature review
Chen Liu, Chuanzhen Xu, Xiaoliang Xu, Yan Zhang, Lei Geng, Yanhui Mei, Hong Ji, Tingliang Fu, Guojian Ding
Frontiers in Pediatrics.2024;[Epub] CrossRef
Cystic lesions of the retrorectal space
Ian S Brown, Anna Sokolova, Christophe Rosty, Rondell P Graham
Histopathology.2023; 82(2): 232. CrossRef
Anal Canal Duplication in a 25-Year-Old Female Patient
Mauricio Gutierrez-Alvarez, Jorge Leal, Kevin Fuentes, Fernando Sotelo, Irving Fuentes, Daniel Camacho
Cureus.2023;[Epub] CrossRef
Anal Canal Duplication Mimicking Recurrent Abscess: A Case Report and Review of the Literature
Dandan Li, Shuaibin Liu, Jiexiong Feng, Jixin Yang
Frontiers in Surgery.2022;[Epub] CrossRef
Early Diagnosis of Anal Canal Duplication: The Importance of a Physical Examination
Ioannis Karamatzanis, Panagiota Kosmidou, Stavros Harmanis, Ioannis Karamatzanis, Giorgos Harmanis
Cureus.2022;[Epub] CrossRef
Case Report: Anal canal duplication associated with anorectal stenosis—A rare presentation
Zhen Zheng, Dong Xiao, Junxiang Wang, Haozhong Xu, Jianxiong Mao, Xiuliang Wang
Frontiers in Pediatrics.2022;[Epub] CrossRef
Anal Canal Duplication in an Adult Female—Case Report and Pathology Guiding
Tudor Mateescu, Cristi Tarta, Paul Stanciu, Alis Dema, Fulger Lazar
Medicina.2021; 57(11): 1205. CrossRef
Anal duplication: is surgery indicated? A report of three cases and review of the literature
A. C. Trecartin, A. Peña, M. Lovell, J. Bruny, C. Mueller, M. Urquidi, Andrea Bischoff
Pediatric Surgery International.2019; 35(9): 971. CrossRef
Anal Canal Duplication Associated with Presacral Cyst in an Adult
Takayuki Toyonaga, Hiromitsu Matsuda, Ryuichi Mibu, Yohei Tominaga, Keiji Hirata, Masafumi Takeyoshi, Masazumi Tsuneyoshi
Journal of the Anus, Rectum and Colon.2018; 2(1): 31. CrossRef
Anal canal duplication presenting with abscess formation
Shohei Honda, Masashi Minato, Hisayuki Miyagi, Hiromi Okada, Akinobu Taketomi
Pediatrics International.2017; 59(4): 500. CrossRef
Anal canal duplication and triplication: a rare entity with different presentations
P. Palazon, V. Julia, L. Saura, I. de Haro, M. Bejarano, C. Rovira, X. Tarrado
Pediatric Surgery International.2017; 33(5): 609. CrossRef

Acute Peritonitis Caused by a Fibrosarcoma of the Transverse Colon in an Adult: Seok Youn Lee, Jung Nam Kwon, Keun Young Kim; Ann Coloproctol. 2014;30(6):280-284. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.280

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Abstract PDF: A fibrosarcoma is a malignant mesenchymal tumor derived from fibrous connective tissue. It usually develops in the deep soft tissues of the extremities, as well as the trunk, head, and neck. In extremely rare cases, a fibrosarcoma may occur in the gastrointestinal tract. Most cases of fibrosarcoma in the gastrointestinal tract have been observed in the pediatric age group while only a few cases have been reported in adults. A 61-year-old male presented with pain in the entire abdominal region. Chest radiography showed free air in the subphrenic space. After an emergency operation, we found a solid mass around the transverse colon and performed a segmental resection with a lymphatic dissection of the transverse colon, including the mass. A pathologic examination showed a fibrosarcoma with a perforation. There was no perioperative complication. The patient was discharged on postoperative day 11 and had follow-ups for 1 year without any recurrence.

Multiple Presacral Teratomas in an 18-year-old Girl: A Case Report: Young Jin Park; J Korean Soc Coloproctol. 2011;27(2):90-93. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.90

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7 Citations

Abstract PDF

Although the sacrococcygeal area is the most common site for a teratoma in infants, it is a rare site for a teratoma in older patients. Most of the teratomas found in this area in adults are single mass, but in a few cases, multiple masses have been reported. The author reports on the case of an 18-year-old female patient with 3 presacral teratomas. The tumors were surgically removed via a transabdominal approach and were pathologically diagnosed as mature cystic teratomas. This case report indicates that an adult presacral teratoma can appear as multiple tumors, although it is very unusual.

Citations

Citations to this article as recorded by

Differential diagnostics of pilonidal cysts
Denis A. Zvonkov, Natalya M. Stepanova, Vladimir A. Novozhilov, Ivan S. Sharapov, Marina I. Stupina, Julia A. Naryshkina, Margarita N. Ludwig
Russian Journal of Pediatric Surgery.2024; 28(6): 594. CrossRef
Perirectal epidermoid cyst in a patient with sacrococcygeal scoliosis and anal sinus: A case report
Zhou-Xin Ji, Song Yan, Xu-Can Gao, Li-Fen Lin, Qiang Li, Qi Yao, Dong Wang
World Journal of Clinical Cases.2022; 10(30): 11139. CrossRef
Adult sacrococcygeal teratoma: A review
Jia-Xing Guo, Jian-Guo Zhao, Ying-Na Bao
Medicine.2022; 101(52): e32410. CrossRef
A Rare Case of Sacrococcygeal Teratoma in Adult
Abhilasha Goyal, Praveen S Rathod, Pallavi V Reddihalli, Shobha Krishnappa, S. K. Rajshekar, Yamini Kansal, Sravanthi Nuthalapati, Amarinder Singh, Tejas Vanakudri, S. D. S. Karthik
Indian Journal of Surgical Oncology.2020; 11(S1): 102. CrossRef
Currarino syndrome with two synchronous presacral teratomas
Timothy A. Little, Kathryn E. Compson, Katherine Hall, M. Jean Murdoch, Katherine R. Neas, Diane Kenwright, Mark D. Stringer
Journal of Pediatric Surgery Case Reports.2018; 36: 16. CrossRef
Giant Type II Sacroccocygial Teratoma: A Senegalese Case
Balla Diop, Dia Aliou Amadou, Sow Oumar, Ba Abdoulaye Pape, Dial Chérif, A. Phiri, Youhanidou Wane, Sarre Mamadou Serigne
Journal of Gynecologic Surgery.2017; 33(6): 264. CrossRef
Sacrococcygeal teratoma – case report and review of the literature
Krzysztof Szyllo, Natalia Lesnik
American Journal of Case Reports.2013; 14: 1. CrossRef

Original Articles

Adult Intussusception: Diagnosis and Treatment.: Yang, Jae Do , Lee, Min Ro , Kim, Jong Hun; J Korean Soc Coloproctol. 2007;23(6):416-419.; DOI: https://doi.org/10.3393/jksc.2007.23.6.416

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2 Citations

Abstract PDF

PURPOSE
Adult intussusception occurs infrequently and differs greatly from childhood intussusception in etiology. Proper diagnostic of and surgical therapeutic methods for adult intussusception remain controversial. The aim of this study was to determine useful diagnostic modalities and proper surgical interventions in adult intussusception.
METHODS
A retrospective analysis performed at Chonbuk National University Hospital identified 38 patients, aged 15 and older, with a diagnosis of intussusception from January 1991 to January 2007.
RESULTS
There were 19 males and 19 females. The median age of the group was 44 years with a range of 20 to 80 years. The mean follow-up period was 82 months. Abdominal pain was the most common presenting complaint (89%). There were 30 small bowel intussusceptions and 8 colonic intussusceptions. A pathologic cause was identified in 79% of the patients, with 5 of 30 (17%) small bowel and 4 of 8 (50%) large bowel lesions being malignant. A preoperative diagnosis was made accurately in 25 of 38 (66%) patients. The diagnostic rates of pre-operative radiological methods were 77%, 60%, 79%, and 100% for barium enema, ultrasonography, abdominal computerized tomography, and both ultrasonography and abdominal computerized tomography, respectively. Operative treatment consisted of manual reduction only in 6 small bowel (20%) and 1 large bowel intussusception (12%), bowel resection after manual reduction in 8 small bowel (27%) and 2 large bowel intussusceptions (24%), and resection alone in 16 small bowel (53%) and 5 large bowel intussusceptions (64%).
CONCLUSIONS
Both ultrasonography and abdominal computerized tomography are the most useful diagnostic modalities. Colonic intussusception should be treated with en-bloc resection without reduction due to the high incidence of malignancy. However, manual reduction only, bowel resection after reduction, and bowel resection alone can be chosen selectively in cases of small bowel intussusception.

Citations

Citations to this article as recorded by

Adult intussusceptions: preoperative predictive factors for malignant lead point
Kil Hwan Kim, Hwan Namgung, Dong Guk Park
Annals of Surgical Treatment and Research.2014; 86(5): 244. CrossRef
A Case of Small Bowel Intussusception Caused by Jejunal Hamartoma Confused as Hepatitis A in an Adult
Joon Hur, Gu-Min Cho, Young Ook Eum, Ji Young Park, Mi Sung Kim, Byung Seong Ko, Hyang Mi Shin, Seung-Myoung Son
Yeungnam University Journal of Medicine.2012; 29(2): 110. CrossRef

Intussusception in Adults.: Yun, Sang On , Namgung, Hwan , Lee, Chang Hwan , Park, Dong Guk; J Korean Soc Coloproctol. 2004;20(4):199-204.

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Abstract PDF: PURPOSE
Intussusception in adults is uncommon and constitutes approximately 5% of all intussusceptions. An organic lesion is found to be the lead point in 75 to 90% of the cases, so surgical intervention is necessary in most cases. This study was designed to review our experience with adult intussusception and to determine an appropriate method for diagnosis and management.
METHODS
Thirteen (13) patients over 15 years of age were diagnosed as having on intussusception at our center between 1994 and 2003. We reviewed the medical records of these patients retrospectively.
RESULTS
The preoperative diagnosis had been made correctly in 85% of patients (11 cases) by combined use of abdominal ultrasonography and a CT scan. The types of intussusceptions wene jejuno-jejunal in two cases, ileo-ileal in four, ileo-colic in three, and colo-colic in four. Causative organic lesion was found in all patients; seven cases (54%) were due to benign tumors, and six (46%) were due to malignant tumors. Surgical intervention was carried out in all cases; 11 patients underwent a surgical resection without manual reduction, and 2 patients underwent a surgical resection after manual reduction.
CONCLUSIONS
Both abdominal ultrasonography and CT scan are effective and useful diagnostic tools in the diagnosis of adult intussusception. Since tumors, benign or malignant, are the most frequent cause of adult intussusception, surgical intervention is mandatory.

Case Report

Hirschsprung's Disease in Adults.: Park, In Ja , Yu, Chang Sik , Yu, Sang Hwa , Lee, Kang Hong , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2003;19(4):254-259.

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Abstract PDF: Hirschsprung's disease is a disorder caused by the absence of ganglion cells in the colon and rectum. It has an incidence of 1 in 5000 births, the majority diagnosed and treated in the neonatal period due to symptoms of intestinal obstruction. Persistence of Hirschsprung's disease into adulthood is very rare. In such patients, prolonged periods of constipation are a common problem. For the diagnosis, a colon study and anorectal manometry are performed, and the presence of the disease is confirmed by an excisional biopsy proving the absence of the ganglion cell in Auerbach and Meissner's plexus. Although various surgical procedures have been performed, there is no obvious optimal choice for treatment of Hirschsprung's disease in adolescents and adults. We experienced two cases of Hirschsprung's disease, confirmed by a rectal biopsy, in 20-year patients. Prior to a definitive operation, a sigmoid loop colostomy was performed due to severe dilatation of the left colon and rectum. Six months later, one patient was treated using Duhamel's procedure, and the other by using a proctosigmoidectomy and coloanal anastomosis. No postoperative complications were observed, and the patients had bowel movements three to four times a day. Despite its infrequent incidence, adult Hirschsprung's disease should be suspected in patients who have had lifelong constipation. Several successful surgical treatments have been used for treatment of patients with adult Hirschsprung's disease. In our cases, the functional results of Duhamels' procedure and of a proctosigmoidectomy with coloanal anastomosis were satisfactory.

Original Article

Etiology and Management for Adult Intussusception.: Park, Sung Won , Kim, Hee Cheol , Cho, Young Kyu , Hong, Hyoun Ki , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2001;17(6):304-308.

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Abstract PDF: PURPOSE
Intussusceptions occurring in adults are relatively rare, however, surgery is usually recommended since they frequently accompany organic lesions as predisposing factor. The purpose of this study is to analyze clinical manifestations and investigate optimal treatment principles for adult intussusception.
METHODS
Clinicopathogic manifestations of 28 adult intussusception patient were analyzied, retrospectively. The types of adult intussusception were classified as enteric and colonic types. Sex ratio was 15:13 and mean age was 52 (17-80) years.
RESULTS
CT scan was the most accurate tool for diagnosis of adult intussusception and detection of underlying causes. The types of adult intussusception were 4 jejuno-jejunal, 7 ileo-ileal, 15 ileo-cecal, and 2 colo-colic types. The pathologic lesions were identified in 23 out of 28 cases (82%). Malignancy was the cause of adult intussusception in 5 cases (45%) of enteric type and in 6 cases (35%) of colonic type intussusception. Operations were performed in 26 cases (93%) and resection without reduction was performed in 23 cases.
CONCLUSIONS
Surgical exploration without reduction may be the treatment of choice since the majority of cases have organic lesions as the etiology, with relatively frequent association of malignancies.

Case Report

Two Cases of Adult Intussusception.: Chae, Gyeong Rae , Cheon, Heui Doo , Tae, Hyong Jin , Kim, Cheol Seung , Lee, Kwang Min , Ju, Myong Jin; J Korean Soc Coloproctol. 2001;17(2):103-107.

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Abstract PDF: Intussusception can develop at any age but about 95% of patients are children under 2 years-old. Adult intussusception is a rare condition. Unlike children, nearly all adults with intussusception have a lead point such as benign or malignant small bowel tumors, intestinal tuberculosis, or Meckel's diverticulum. First case is a 48-year-old male who was admitted with 2 days of diffuse abdominal cramping pain and no other associated gastrointestinal symptoms. Barium enema revealed ileocolic intussusception with a round cecal mass after barium reduction. An ileocecectomy was performed electively. The pathologic report was cecal cyst, which was an intraluminal structure with an epithelial lining of colonic mucosa. The second case, a 53-year-old male, was admitted with 1 week of diffuse abdominal cramping pain and watery diarrhea. Barium enema revealed ileocecal intussusception. Emergency surgery (ileocecectomy), revealed a polypoid small bowel mass. The pathologic report was lipoma. Recently, we experienced two cases of adult intussusception and report these cases with a brief review of the literature.

Original Articles

An Adult with Symptomatic Isolated Cecocolic Nonrotation.: Chung, Seo Jin , Park, Seong Heum , Yoon, Seo Gue , Park, Ghi Goo , Choi, Kyung Woo; J Korean Soc Coloproctol. 1998;14(3):675-680.

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Abstract PDF: On the contrary to congenital anomalies of intestinal rotation in pediatric patients, those in adults are generally nonsymptomatic and of little consequence. Occasionally, however, an adult may have midgut nonrotation and complain of chronic or recurrent abdominal pain. Intestinal nonrotation can be divided into complete or partial failure of rotation and into abnormalities affecting the proximal segment, the distal segment or both. We report herein a 43-year old female patient with symptomatic partial, cecocolic nonrotation.

Abdominal CT Scanning in Adult Intussusception.: Kim, Se Woong , Cho, Young Up , Ko, Young Bae , Kim, Won Gon , Kim, Kyung Kook , Kim, Kyun Rae , Woo, Ze Hong , Kim, Mi Yong; J Korean Soc Coloproctol. 1998;14(3):585-594.

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Abstract PDF: Intussusception is a relatively common disease in children, but it is a rare clinical entity in adults. More than 80% of all patients with intussusception are less than two years of age, but adults account for only 5 to 10 percent of all intussusception cases. The significance of this disease in the aspect of statistics is mentioned as "rule of fives", which means 5% of all intussusceptions occur in adults, and it accounts for up to 5% of all cases of bowel obstruction in adults. In children, classic symptoms include episodic abdominal pain, "current-jelly" stool and a sausage-shaped abdominal mass on examination. However, in adults, it is likely to appear with non-specific gastrointestinal trouble without classic symptoms. Therefore, it is very important to use early diagnositic tool. In contrast to childhood intussusception, which is idiopathic in 90% of cases, adult intussusception has a definable lesion in more than 90% of cases 3). Tumors, both benign and malignant, are the most frequent cause of intussusecption in adults. We experienced seven cases of adult intussusception at Inha hospital from Jan. 1994 to Dec. 1997. The patients of adult intussusception are classified as three cases of ileoileal type and four ileocecal type. There were no specific signs or symptoms with patient experienced. It included abdominal pain, diarrhea and palpable mass. Their diagnosis was made in six patients using abdominal CT scan. It is difficult to define a diagnosis preoperatively, because the symptom of adult intussusception are variable and insignificant among individuals. We had been taken the final diagnostic tool with the abdominal CT scan in six of seven patients, which revealed "target lesions" in all cases. So, it is useful in the diagnosis of adult intussusception. Bowels were resected for the treatment of adult intussusception. The extent of the resection was contained the lesion and the defunctioned segments. The operations were performed as four segmental resections of small bowel and three ileocecal resections. The pathological findings were disclosed as three tumors, three lymphadenopathies and a adhesion of bowel. We concluded that the abdominal CT scanning is a usefull diagnostic tool in the diagnosis of adult intussusception.

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