Annals of Coloproctology

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Original Article

Anorectal physiology & pelvic floor disorder

Transverse perineal support improves long-term outcomes in patients undergoing stapled transanal rectal resection for obstructed defecation syndrome: a multicenter observational case-control study: Adolfo Renzi, Luigi Marano, Pasquale Talento, Luigi Brusciano, Angela Pezzolla, Domenico Izzo, Carmine Antropoli, Francesco D’Aniello, Giandomenico Di Sarno, Gianluca Minieri, Grazia Cantore, Gianmattia Terracciano, Domenico Barbato, Ludovico Docimo, Massimo Antropoli, Alessio Palumbo, Michele Lanza, Emanuele Mario Caputi, Antonio Brillantino; Ann Coloproctol. 2025;41(4):330-337. Published online August 25, 2025; DOI: https://doi.org/10.3393/ac.2025.00073.0010

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Abstract PDF: Purpose
To evaluate the safety and long-term efficacy of stapled transanal rectal resection (STARR) combined with the transverse perineal support (TPS) procedure in the surgical treatment of obstructed defecation syndrome (ODS) associated with internal rectal prolapse and excessive perineal descent (PD).
Methods
This multicenter observational case-control study involved 7 European centers. During the initial study period, patients underwent STARR alone (group 1), while in the subsequent period, patients received STARR combined with TPS (group 2). All patients were followed clinically at 6, 12, 36, and 60 months, and were offered radiological evaluation between 3 and 5 years postoperatively.
Results
The median postoperative ODS score was similar between groups at 6 months (6 [range, 2–15] vs. 5 [range, 2–13]; P=0.16, Mann-Whitney U-test), but at 36 months, it was significantly lower in group 2 compared to group 1 (11 [range, 5–16] vs. 5 [range, 2–15]; P<0.001, Mann-Whitney U-test), with stable results maintained through 5 years. The success rate followed a similar trend. Postoperative maximum PD during straining remained unchanged in group 1, whereas it significantly decreased compared to preoperative values in group 2.
Conclusion
The addition of TPS to STARR in the surgical treatment of ODS associated with internal rectal prolapse and excessive PD appears to significantly improve long-term success rates and correct descending perineum.

Case Reports

Benign bowel disease

A case report of impacted fecalith within mucosal pouch: an unusual cause of colocolic intussusception: Douglas Greer, Adrian Fernandez; Ann Coloproctol. 2024;40(Suppl 1):S15-S17. Published online November 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00724.0103

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Abstract PDF: Intussusception involving the colon is unusual in adults and when present is managed with resection due to the risk of malignancy. We present an unusual case where the intussusceptum was impacted stool in a mucosal pouch in the transverse colon. The patient presented with bleeding per rectum and abdominal pain and was found to have a colocolic intussusception on computed tomography. Colonoscopy showed an ulcerated mass in the transverse colon. A laparoscopic right hemicolectomy was performed. Histopathology demonstrated known chronic lymphocytic leukemia, but not solid malignancy. A large fecalith impacted within a mucosal pouch had acted as the lead point. This represents a highly unusual but benign cause of intussusception.

Multiple gastrointestinal melanoma causing small bowel intussusception: Jian Yang Eng, Salehah Tahkin, Huzairi Yaacob, Nor Hayati Yunus, Ahmad Shan Wani Mohamed Sidek, Michael Pak-Kai Wong; Ann Coloproctol. 2023;39(1):85-88. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00143.0020

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Abstract PDF

A 61-year-old gentleman presented with small bowel intussusception from small bowel melanoma intussusceptum. He complains of intermittent abdominal distension but no history of intestinal obstruction. Apart from this, he was also symptomatic anemia which required repeated transfusion for the past few months. The contrast-enhanced computed tomography of the abdomen shows an omental mass with small bowel intussusception. He then underwent an exploratory laparotomy with segmental resection of the affected segment. Histopathological examination confirmed primary gastrointestinal melanoma. Multiple small bowel malignant melanoma is a rare disease. It remains a controversial diagnosis as it may be a primary or metastasis from an unidentified or regressed primary cutaneous melanoma. Prompt surgical intervention enables us to obtain tissue diagnosis, prevent complete intestinal obstruction and strategize the goals of treatment for the patient.

Citations

Citations to this article as recorded by

Small bowel melanoma causing obstruction: A case report and a literature review
Ammar Mattit, Ibrahim Marrawi, Safouh Kheir, Taha Khamis, Safaa Qatleesh, Muhammad Ali Ousta
International Journal of Surgery Case Reports.2024; 116: 109388. CrossRef
Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis
Niraj James Shah, Mark M. Aloysius, Eldrin Bhanat, Shweta Gupta, Ganesh Aswath, Savio John, Shou-Jiang Tang, Hemant Goyal
BMC Gastroenterology.2022;[Epub] CrossRef

Benign GI diease,Benign diesease & IBD

Ileocolonic intussusception caused by epithelioid leiomyosarcoma of the ileum: a report of case and review of the literature: Han-Gil Kim, Jung Wook Yang, Soon-Chan Hong, Young-Tae Ju, Chi-Young Jeong, Ju-Yeon Kim, Ji-Ho Park, Jin-Kwon Lee, Jae-Myung Kim, Jin-Kyu Cho, Seung-Jin Kwag; Ann Coloproctol. 2022;38(2):176-180. Published online May 28, 2021; DOI: https://doi.org/10.3393/ac.2020.12.08

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Abstract PDF

Small intestinal malignant tumor accounts for about 3% of all malignant tumors in the gastrointestinal tract, among which 13% are leiomyosarcoma (LMS). In addition, epithelioid LMS is of very rare occurrence. As small intestinal malignant tumors are initially asymptomatic and nonspecific, diagnosis is often delayed, and this can lead to large tumor at the time of detection and lead to intussusception. We observed ileocolonic intussusception in an 80-year-old male patient who was admitted to the hospital with a complaint of abdominal pain and palpable mass on right lower quadrant. The laparoscopic ileocecectomy was performed by the emergency operation because of obstruction. The pathologic examination revealed that the epithelioid LMS developed in the terminal ileum was the leading point of intussusception. To the best of our knowledge, laparoscopic surgery for ileocolonic intussusception with epithelioid LMS has not yet been reported.

Citations

Citations to this article as recorded by

Squamous cell carcinoma of the small intestine: a case report and review of literature
Dandan Wang, Zhe-Xuan Li, Lanlin Hu, Ying Wang, Senlin Xu, Chuan Xu
Frontiers in Oncology.2025;[Epub] CrossRef
Small bowel leiomyosarcoma: a case report and review of the literature
Rebaz O Mohammed, Rawa M Ali, Deari A Ismaeil, Rebaz M Ali, Hemn H Kaka Ali, Karokh F Hamahussein, Omar H G Hawramy, Hiwa O Abdullah, Marwan A Ghafoor, Fahmi H Kakamad
Journal of Surgical Case Reports.2025;[Epub] CrossRef
Ileum intussusception secondary to submucosal liposarcoma in adult：A case report
Hong-wei Yu, Jin-gang Yan, Lei Zheng, Jun-hua Huang
Heliyon.2024; 10(1): e23432. CrossRef
Current landscape of primary small bowel leiomyosarcoma: cases report and a decade of insights
Junjie Zhou, Houyun Xu, Jibo Hu, Qiang Hong, Xiping Yu, Wei Liu, Jiaxin Zhao, Hongjie Hu
Frontiers in Oncology.2024;[Epub] CrossRef

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 Web of Science
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

Inflammatory Fibroid Polyp in the Jejunum Causing Small Bowel Intussusception: Sung Hoon Kang, Seok Won Kim, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong, Jin Su Kim, Gyu Sang Song; Ann Coloproctol. 2015;31(3):106-109. Published online June 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.3.106

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51 Download
7 Web of Science
11 Citations

Abstract PDF

Intussusceptions are defined as the telescoping of one segment of the gastrointestinal tract into an adjacent distal segment. In the small bowel, intussusceptions are typically caused by benign processes, but can occasionally be caused by inflammatory fibroid polyps, which often present as intussusception and bowel obstruction. These polyps are rare, benign, tumorous lesions in the gastrointestinal tract and are typically observed in the stomach, but can occur anywhere in the gastrointestinal tract. Any case of a jejunojejunal intussusception caused by inflammatory fibroid polyps is considered rare, and we report the case of a 51-year-old woman with an inflammatory fibroid polyp of the jejunum presenting as an intussusception who was successfully treated with a resection.

Citations

Citations to this article as recorded by

PÓLIPO FIBROSO INFLAMATÓRIO EM TRATO GASTROINTESTINAL, UM DIAGNÓSTICO DIFERENCIAL DE INTUSSUSCEPÇÃO INTESTINAL EM ADULTO: RELATO DE CASO E REVISÃO
Raul Valério Ponte, Priscila Ferreira de Lima e Souza, Raíra Marques Oliveira, Bruna Viana Teles Rebouças, Sarah Mombach de Arruda, Isabella Siqueira Oliveira, Kalyne Saraiva Fontenele de Araújo, Maria Eduarda Lima Lobão Maia
Revista Contemporânea.2024; 4(9): e5834. CrossRef
Jejunal Intussusception Secondary to a Large Inflammatory Fibroid Polyp: A Case Report and Discussion of Differential Diagnosis
Asma Khalid Abu-Salah, Eric Brocken, Hector Mesa, Katrina Collins, Mirella Marino
Case Reports in Pathology.2023; 2023: 1. CrossRef
Inflammatory fibroid polyp (Vanek's tumor) causing double compound ileo-ileal intussusception in an adult patient, a case report
Ahmed Gadoura, Farah Mohammed, Mohamed Abdulkarim, Ammar Ibn Yasir, Dafalla Shani, Nadir Salih
International Journal of Surgery Case Reports.2022; 93: 106947. CrossRef
Adult intussusception due to ileal polyp - A case report
Tahmina Hakim
International Journal of Surgery Case Reports.2022; 99: 107554. CrossRef
Ileal Intussusception in an Adult Caused by a Locally Invasive Inflammatory Fibroid Polyp: A Case Report
Luiz M. Nova, Paul Lopez, Clara Cerezo, Concepción Llanos, Irene Amat
Revista Española de Patología.2021; 54(1): 65. CrossRef
Adult Jejuno-jejunal intussusception due to inflammatory fibroid polyp
Yi-Kai Kao, Jian-Han Chen
Medicine.2020; 99(36): e22080. CrossRef
Adult Jejuno-Jejunal Intussusceptions due to Gastrointestinal Stromal Tumor
Jayabal Pandiaraja
Indian Journal of Medical and Paediatric Oncology.2020; 41(04): 602. CrossRef
Laparoscopic Resection of a Jejunal Inflammatory Fibroid Polyp that Caused Occult Gastrointestinal Bleeding, Diagnosed via Capsule Endoscopy and Double-Balloon Enteroscopy: A Case Report
Chizu Kameda, Hideaki Miwa, Ryohei Kawabata, Daiki Marukawa, Masahiro Murakami, Shingo Noura, Junzo Shimizu, Junichi Hasegawa
Clinical Endoscopy.2018; 51(4): 384. CrossRef
Inflammatory fibroid polyps of the appendix: different presentation and literature review
Ibrahim Albabtain, Hassan Arishi, Slava Albaghli, Jumanah Aljahani
Journal of Surgical Case Reports.2018;[Epub] CrossRef
Pólipo fibroideo inflamatorio del tracto gastrointestinal: 10 años de experiencia del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
A.F. Romano-Munive, R. Barreto-Zuñiga, J.A. Rumoroso-García, P. Ramos-Martínez
Revista de Gastroenterología de México.2016; 81(3): 134. CrossRef
Inflammatory fibroid polyp of the gastrointestinal tract: 10 years of experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
A.F. Romano-Munive, R. Barreto-Zuñiga, J.A. Rumoroso-García, P. Ramos-Martínez
Revista de Gastroenterología de México (English Edition).2016; 81(3): 134. CrossRef

Surgical Strategy for Colonic Intussusception Caused by a Giant Colonic Lipoma: A Report of Two Cases and a Review of the Literature: Seung-Jin Kwag, Sang-Kyung Choi, Eun-Jung Jung, Chi-Young Jung, Sang-Ho Jung, Tae-Jin Park, Young-Tae Ju; Ann Coloproctol. 2014;30(3):147-150. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.147

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5 Citations

Abstract PDF

A colon lipoma is a remarkably rare tumor. In most cases, the tumors are asymptomatic and small in size, need to be differentiated from malignant tumors, and do not need any special treatment. Selection of the right surgical strategy depends on the status of bowel, as well as the size and the location of tumor. We encountered two patients with giant submucosal lipomas that had induced intussusceptions: one with a lipoma in the transverse colon and the other with a lipoma in the ascending colon. The diagnoses were made by using histological examinations. We report the clinical features, diagnoses, and treatments of, as well as our experience with, these two uncommon cases, and we present a review of the literature on this subject.

Citations

Citations to this article as recorded by

Pedunculated colonic lipoma causing adult colo-colic intussusception: A case report and literature review
Dhouha Bacha, Neirouz Kammoun, Ines Mallek, Lassad Gharbi, Ahlem Lahmar, Sana Ben Slama
International Journal of Surgery Case Reports.2024; 123: 110242. CrossRef
Sizzling Fat—Curative Endoscopic Resection of a Giant Lipoma Causing Colo-Colic Intussusception
Chiara Eberspacher, Stefano Arcieri, Augusto Lauro, Rossella Palma, Enrico Coletta, Francesco Leone Arcieri, Domenico Mascagni, Stefano Pontone
Digestive Diseases and Sciences.2023; 68(11): 4123. CrossRef
Colon lipoma causing intussusception in adults: literature review
Antonio LO CASTO, Marta FARINELLA, Crispino R. TOSTO, Emanuela FARINELLA, Alessandro MASSARA, Vito RODOLICO
Journal of Radiological Review.2022;[Epub] CrossRef
A case of colonic intussusception and obstruction secondary to giant colonic lipoma
Yi Ying Law, Rhea Patel, Marianne Cusick, Jeffrey L Van Eps
Journal of Surgical Case Reports.2020;[Epub] CrossRef
Curative endoscopic treatment of intussusception due to a giant colonic lipoma using a wedged balloon and ligation with detachable snares
Masahiro Okada, Hirotsugu Sakamoto, Yoshikazu Hayashi, Tomonori Yano, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
Clinical Journal of Gastroenterology.2019; 12(4): 320. CrossRef

Giant Ascending Colonic Diverticulum Presenting With Intussusception: Ho Jin Kim, Jin Ha Kim, Ok In Moon, Kyung Jong Kim; Ann Coloproctol. 2013;29(5):209-212. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.209

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10 Citations

Abstract PDF

Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult.

Citations

Citations to this article as recorded by

Intussusception secondary to retroflexion of a proximal jejunal diverticulum, leading to Type 3 vagal indigestion with severe hypochloraemia in an adult Simmental bull (Bos taurus)
Liam A. Wilson, Rob F. Kelly, Adrian W. Philbey
Veterinary Record Case Reports.2024;[Epub] CrossRef
A case report of impacted fecalith within mucosal pouch: an unusual cause of colocolic intussusception
Douglas Greer, Adrian Fernandez
Annals of Coloproctology.2024; 40(Suppl 1): S15. CrossRef
Popping the Balloon: A Giant Colonic Diverticulum Complicated by Bladder Neck Compression
M. C. Ripoli, A. Lauro, S. Vaccari, G. Mastrocola, A. Lanci-Lanci, V. D’Andrea, I. R. Marino, M. Cervellera, V. Tonini
Digestive Diseases and Sciences.2021; 66(1): 41. CrossRef
Laparoscopic resection of a giant colonic diverticulum – the ‘lifting balloon’ sign – a video vignette
C. Rodríguez‐Otero Luppi, M. Rodríguez Blanco, J. Bollo Rodríguez, A. Méndez, J. Merlo Más
Colorectal Disease.2019; 21(9): 1096. CrossRef
Intussusception caused by an inverted colonic diverticulum: a case report
Bei Zhang, Jiping Wang, Xiaoguang Li, Zhuo Wang, Yangjiao Zhang, Hao Yang
Journal of Medical Case Reports.2018;[Epub] CrossRef
Adult intussusception secondary to diverticular disease
Habib Syed, Labib Syed, Umesh Parampalli, Mokhtar Uheba
BMJ Case Reports.2018; 2018: bcr-2018-226678. CrossRef
Laparoskopische Resektion eines Riesenkolondivertikels
P. J. Roch, T. Friedrich, R. Bönninghoff, D. Dinter, A. Rickert
Der Chirurg.2017; 88(8): 682. CrossRef
Giant colonic diverticulum: radiographic and MDCT characteristics
Abdel-Rauf Zeina, Ahmad Mahamid, Alicia Nachtigal, Itamar Ashkenazi, Mika Shapira-Rootman
Insights into Imaging.2015; 6(6): 659. CrossRef
Giant colonic diverticulum: Clinical presentation, diagnosis and treatment: Systematic review of 166 cases
Giuseppe Nigri
World Journal of Gastroenterology.2015; 21(1): 360. CrossRef
Giant Colonic Diverticulum: a Rare Diagnostic and Therapeutic Challenge of Diverticular Disease
Ryan Macht, Holly K. Sheldon, P. Marco Fisichella
Journal of Gastrointestinal Surgery.2015; 19(8): 1559. CrossRef

Laparoscopic Surgery for an Intussusception Caused by a Lipoma in the Ascending Colon: Dong-Nyoung Son, Ho-Geun Jung, Dong-Yeop Ha; Ann Coloproctol. 2013;29(2):80-82. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.80

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3 Citations

Abstract PDF

A colonic intussusception caused by an intraluminal lipoma is a rare disease in adults, in whom it usually has a definite organic cause. In fact, it is either caused by a benign or a malignant condition, both of which occur at similar rates. However, little literature is available on laparoscopic procedures for use in cases of adult colonic intussusceptions. Recently, a 52-year-old woman was admitted to our hospital with abdominal pain of one-month duration. Abdominal computed tomography showed an intussusception with a fat-containing mass in the right hepatic area. Colonoscopy showed a colon lumen occupied by the mass. A right hemicolectomy was performed laparoscopically, and the cause of the intussusception was found to be a lipoma. Before obtaining histological confirmation, we carefully perform a laparoscopic procedure, which required consideration of the relations between the involved colonic segment and other conditions such as the location of main vessels, the anatomical exposure with respect to colonic mobilization and the location of specimen retrieval.

Citations

Citations to this article as recorded by

Colon lipoma causing intussusception in adults: literature review
Antonio LO CASTO, Marta FARINELLA, Crispino R. TOSTO, Emanuela FARINELLA, Alessandro MASSARA, Vito RODOLICO
Journal of Radiological Review.2022;[Epub] CrossRef
Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report
Jiro Shimazaki, Takeshi Nakachi, Takanobu Tabuchi, Shuji Suzuki, Hideyuki Ubukata, Takafumi Tabuchi
World Journal of Surgical Oncology.2015; 13(1): 75. CrossRef
Lipomas of the Colon: A Surgical Challenge
Ketan Vagholkar, Mahendra Bendre
International Journal of Clinical Medicine.2014; 05(06): 309. CrossRef

Adult Intussusception due to Cecal Lymphangioma: A Case Report: Dong Il Kim, Hyung Il Seo, Jae Hun Kim, Hyun Sung Kim, Hong Jae Jo; J Korean Soc Coloproctol. 2011;27(2):99-101. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.99

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8 Citations

Abstract PDF

We present a rare case of adult intussusception due to cecal lymphangioma. A 30-year-old female was admitted to our hospital with abdominal pain and a palpatable mass on the right lower quadrant. Preoperative radiologic studies by ultrasound and computed tomography showed ileocolic intussusception with a multiseptated cystic tumor as a leading point on the cecum. An ileocecectomy was performed, and the postoperative course was uneventful. Histopathology showed a cecal lymphangioma. Although endoscopic polypectomy or endoscopic mucosal resection is recommended for pedunculated or semi-pedunculated colonic lymphangiomas less than 2 cm in size, it is proper to treat large or symptomatic colonic lymphangiomas with limited a bowel resection or a tumor resection.

Citations

Citations to this article as recorded by

A Unusual Twist: Cecal Lymphangioma as an Unusual Culprit in Adult Intussusception
Daniela Avila , Natalie Nagib, Chinwe Okonkwo, Armin Kamyab
Cureus.2025;[Epub] CrossRef
An Incidental Finding of a Cecal Lymphangioma Managed Conservatively
Richard Mitchell, Jonathan Reyes, Vennis Lourdusamy, Raghav Bansal
Cureus.2024;[Epub] CrossRef
A Case of Colonic Intussusception Caused by Cecal Lymphangioma and Requiring Emergency Surgery
Mitsutoshi Okuda, Takahiro Yoshioka, Ryosuke Tsunemitsu, Hiroaki Inoeu, Ryo Inada
Cureus.2024;[Epub] CrossRef
Cystic Lymphangioma of Rectum-A Case Report and Review of Literature
Govindraj S Dessai, Nikhil Kumar Soni, Sharvari Pujari, Ramkrishna Prabhu, Chetan V Kantharia
The Korean Journal of Gastroenterology.2023; 82(2): 91. CrossRef
Cystic lymphangioma causing intussusception of the right colon: a case report and review of current literature
Jae Hyun Park, Jesung Park, Ga Yoon Ku, Do Kyoon Moon, Jong Sung Ahn, Hyo Jun Kim, Min Jung Kim, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
Journal of Surgical Case Reports.2023;[Epub] CrossRef
Imaging features, complications and differential diagnoses of abdominal cystic lymphangiomas
M. Raufaste Tistet, O. Ernst, M. Lanchou, M. Vermersch, P. Lebert
Abdominal Radiology.2020; 45(11): 3589. CrossRef
Colonic lymphangioma presenting with intermittent pain and intussusception
Mark M G Ly, Marie Shella De Robles, Catriona Mckenzie, Christopher J Young
Journal of Surgical Case Reports.2019;[Epub] CrossRef
A Case of Adult Intussusception Secondary to Lymphangioma of the Cecum
Seong Wook Hwang
Soonchunhyang Medical Science.2019; 25(2): 139. CrossRef

Laparoscopic Treatment of Adult Sigmoidorectal Intussusception Caused by a Mucinous Adenocarcinoma of the Sigmoid Colon: A Case Report: Seok Youn Lee, Won Cheol Park, Jeong Kyun Lee, Dong Baek Kang, Young Kim, Ki Jung Yun; J Korean Soc Coloproctol. 2011;27(1):44-49. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.44

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3 Citations

Abstract PDF

Intussusception is a rare cause of intestinal obstruction in adult patients, but is common in children. In fact, it accounts for an estimated 1% of all cases of bowel obstruction in adults, although adult intussusception of the large intestine is rare. Sigmoidorectal intussusception, however, is a rare variety with few cases reported in the literature. A mucinous adenocarcinoma, a subtype of adenocarcinoma, is characterized by extracellular mucin production and accounts for between 5% and 15% of the neoplasms of the colon and rectum. Despite the general consensus supporting surgical resections for adult intussuceptions, controversy remains over whether intussuceptions should be reduced before resection. Most cases of colon intussusception should not be reduced before resection because they most likely represent a primary adenocarcinoma. However, prior reduction followed by a resection can be considered for the sigmoidorectal intussusception to avoid inadvertent low rectal cancer sugery. We experienced one case of sigmoidorectal intussusception caused by a mucinous adenocarcinoma of the sigmoid colon in a 79-year-old woman. Abdominal computed tomography demonstrated a sigmoidorectal intussusception. After the end-to-end anastomosis-dilator-assisted reduction, the patient underwent a laparoscopic oncological anterior resection under the impression that a sigmoidorectal intussusception existed. We report a successful laparoscopic anterior resection in a patient with an intussusception caused by a sigmoid malignant tumor.

Citations

Citations to this article as recorded by

Laparoscopic Reduction of Sigmoidorectal Intussusception by a Modified Hutchinson’s Maneuver
Haruna Onoyama, Takashi Nakamura, Yuka Ahiko, Naoki Sakuyama, Susumu Aikou, Dai Shida
Indian Journal of Surgery.2024; 86(2): 428. CrossRef
Strangulated appendiceal intussusception caused by isolated endometriosis
Seokyoun Lee, Junhee Lee, Keunyoung Kim
Clinical and Experimental Emergency Medicine.2021; 8(3): 246. CrossRef
Unusual causes of large bowel obstruction
Nicholas G. Farkas, Ted Joseph P. Welman, Talisa Ross, Sarah Brown, Jason J. Smith, Nikhil Pawa
Current Problems in Surgery.2019; 56(2): 49. CrossRef

Laparoscopic Management of Appendiceal Intussusception Caused by Fecaliths.: Kang, Dong Baek , Kim, Seung Ho , Oh, Jung Taek , Kim, Kang Deuk , Jo, Hyang Jeong , Lee, Jeong Kyun , Park, Won Cheol; J Korean Soc Coloproctol. 2009;25(5):352-355.; DOI: https://doi.org/10.3393/jksc.2009.25.5.352

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1 Citations

Abstract PDF

Appendiceal intussusception is a rare condition of abdominal pain. It develops as a result of various anatomic or pathologic conditions, such as polyps, worms, carcinomas, mucoceles, or fecaliths. Furthermore, an accurate preoperative diagnosis of appendiceal intussusception may be difficult. However, recently developed radiologic modalities, such as multidetector CT and laparoscopy, can considerably aid preoperative diagnosis and provide a means of adopting optimal minimally invasive surgery. Here, the authors describe the case of a 30-yr-old woman with the clinical features of acute appendicitis, who was preoperatively diagnosed as having appendiceal intussusception with fecaliths and who was managed by using a laparoscopic partial cecectomy.

Citations

Citations to this article as recorded by

Appendix Invagination Mimicking Ileocecal Intussusception in a Pediatric Patient: A Case Report
Muhsin Nuh Aybay, Seyit Erol, Hasan Emin Kaya, Ibrahim Guler
The Journal of Emergency Medicine.2016; 51(5): 589. CrossRef

Adult Sigmoido-recto-anal Intussusception by a Sigmoid Colon Adenoma.: Park, Young Jin; J Korean Soc Coloproctol. 2009;25(2):121-124.; DOI: https://doi.org/10.3393/jksc.2009.25.2.121

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Abstract PDF

Although rectal procidentia is not an uncommon disease, presentation of more proximal segments of the large bowel through the anus is extremely rare. A case with sigmoido-recto-anal prolapse secondary to a large adenoma of the sigmoid colon is reported herein. A 28-yr-old man with an anal prolapsing mass was admitted to our hospital. Preoperative CT scan showed a sigmoid-recto-anal prolapse. An emergency operation was decided upon because the prolapsed segment was irreducible and because its viability was questionable. After a manual reduction of the mass, an anterior resection was performed under general anesthesia. The pathologic diagnosis of the resected specimen was a large villo-tubular adenoma.

Citations

Citations to this article as recorded by

Laparoscopic Treatment of Adult Sigmoidorectal Intussusception Caused by a Mucinous Adenocarcinoma of the Sigmoid Colon: A Case Report
Seok Youn Lee, Won Cheol Park, Jeong Kyun Lee, Dong Baek Kang, Young Kim, Ki Jung Yun
Journal of the Korean Society of Coloproctology.2011; 27(1): 44. CrossRef

Appendiceal Intussusception Resected by Laparoscopy.: Park, Jin Young; J Korean Soc Coloproctol. 2008;24(3):223-227.; DOI: https://doi.org/10.3393/jksc.2008.24.3.223

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Abstract PDF: The appendix has been reported to be a very rare leading point in intussusception with an incidence of 0.01% in surgical and postmortem specimens. In many cases it was developed by secondary conditions, such as polyps, carcinomas, or mucoceles. Some other cases had none of the initiating causes. Therefore, making an accurate diagnosis is important in providing the optimal treatment for the patient. Here, the author presents an appendiceal intussusception case of a 37-year-old male patient whose vermiform appendix had none of the initiating causes. The preoperative diagnosis was an appendiceal mucocele, but an appendiceal intussusception was detected after the operation. The patient was managed with a laparoscopic partial cecectomy and has been followed up.

Spontaneous Jejunal Intussusception after a Colectomy: A Rare Cause of Postoperative Intestinal Obstruction: A Case Report.: Lim, Seok Byung , Chang, Hee Jin , Jeong, Jun Yong , Choi, Hyo Seong , Jeong, Seung Yong; J Korean Soc Coloproctol. 2008;24(2):134-136.; DOI: https://doi.org/10.3393/jksc.2008.24.2.134

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Abstract PDF: Intussusception is a rare cause of intestinal obstruction in adults and is most often due to a primary abnormality of the bowel, which serves as the leading point. Idiopathic intussusception in adults is distinctly uncommon, comprising 10% of diagnosed intussusceptions. We report a case of a spontaneous jejunal intussusception in a 48-year-old man that developed shortly after an open colectomy. The 48-year-old man, with no history of a laparotomy, underwent a left hemicolectomy and a left hemihepatectomy for descending colon cancer with liver metastasis. For 14 postoperative days, the patient complained of ileus, and conservative management with a long intestinal tube failed. When the patient underwent a laparotomy, intussusception of the mid jejunum was observed. The intussusception was resected, and no underlying bowel abnormality was identified. This report highlights the importance of considering this rare etiology in patients with ileus who have recently undergone a laparotomy.

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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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

The Clinical and Physiologic Characteristics of Patients with Pelvic Outlet Obstructive Disease.: Ahn, Eun Jung , Jeong, Gyu Young , Cheon, Seung Hui , Lee, Eun Joung , Oh, Soo Youn , Chung, Soon Sup , Lee, Ryung Ah , Kim, Kwang Ho , Park, Eung Bum; J Korean Soc Coloproctol. 2005;21(6):362-369.

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Abstract PDF: PURPOSE
With recent anorectal physiologic studies, functional etiologies of pelvic outlet obstructive disease were evaluated in detail. The current study was designed to assess the clinical and the physiologic characteristics of patients with pelvic outlet obstructive disease.
METHODS
one hundred two (102) patients with pelvic outlet obstructive disease were evaluated with anorectal physiologic studies, including the colonic transit time (n=66), anorectal manometry (n=88), defecography (n=102), anal sphincter EMG (n=50), and colonoscopy or barium enema (n=77). The patients were categorized as group I (nonrelaxing puborectalis syndrome), group II (rectocele), group III (sigmoidocele), and group IV (rectoanal intussusception). The clinical and the physiologic characteristics were compared between the groups.
RESULTS
The mean age was 51.9 years, and the sex ratio was 1:1.9. the populations of the groups were group I 45.1% (n=46), group II 36.3% (n=37), group III 5.9% (n=6), and group IV 9.8% (n=10). In group II and group III, co-existing etiologies were more, and the incidences of female patients was higher (P<0.05). Delayed colonic transit time was noted in 11 patients (17%). Diverticula was observed in 6 patients (8%), polyps in 12 patients (16%), and melanosis coli in 14 patients (18%). On anorectal manometry, group I showed higher maximal voluntary contraction and mean squeezing pressure than the other groups (P<0.05). On defecography, group I had a shorter perineal descent at rest and a smaller anorectal angle at push (P<0.05).
CONCLUSIONS
The current study showed the clinical and the physiologic characteristics of the each functional etiology in patients with pelvic outlet obstructive disease. These results provide fundamental data for diagnosis of and tailored therapy for pelvic outlet obstructive disease.

Case Report

Peutz-Jeghers Syndrome with Intussusception and Anemia.: Hwang, Jeong Kye , Kang, Won Kyung , Lee, Sang Chul , Lee, Yoon Suk , Park, Seung Man , Rha, Sung Eun , Oh, Seong Taek; J Korean Soc Coloproctol. 2004;20(4):231-235.

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Abstract PDF: Peutz-Jeghers syndrome is a disease entity consisting of gastrointestinal hamartoma, mucocutaneous pigmentation, and autosomal dominant inheritance. From a surgical standpoint, the syndrome is of significance because the hamartoma may lead to intussusception, gastrointestinal bleeding, abdominal pain, and a fifteen-times-increased risk of malignancy in the GI tract, pancreas, breast, ovarles, and testes. Recent reports indicate the STK11 (LKB1) gene, located on region 13.3 of the short arm of chromosome 19, as being the locus of autosomal dominant indentify. The case of a 21-year-old female who required a partial jejunal resection due to intussusception and bleeding from a jejunal hamartoma twice in five years is presented.

Original Articles

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.

Outcome and Predictors of Biofeedback Therapy for Patients with Internal Rectal Intussusception.: Kwon, Soon Ho , Hwang, Yong Hee , Choi, Kun Pil; J Korean Soc Coloproctol. 2002;18(6):379-385.

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Abstract PDF: PURPOSE
The aim of this study was to determine the outcome and identify predictors of success of biofeedback therapy for patients with internal rectal intussusception.
METHODS
Twenty-one patients (median age. 54 years, 15 female, 6 male) diagnosed with internal rectal intussusception by using cinedefecography were evaluated by standardized questionnaire, before, immediately after treatment, and at follow-up. Clinical bowel symptoms and anorectal physiological studies were also analyzed.
RESULTS
Follow up (median: 15, range 2~24 months) results were evaluated by an independent observer in 20 patients. At post-biofeedback, 20 (95%) patients felt improvement in symptoms, including 7 (33%) with complete symptom relief. At follow-up, 17 (85%) patients felt improvement in symptoms, including 7 (35%) with complete symptom relief. There was a significant reduction in difficult defecation (from 90 to 29, 10 percent, from pre-biofeedback to post-biofeedback, and at follow up respectively; P<0.001), sensation of incomplete defecation (from 90 to 24, 35 percent; P<0.001), enema use (from 29 to 0, 0 percent; P<0.01), and anal pain (from 19 to 0, 0 percent; P<0.05). Digitation (from 19 to 0 percent, from pre- biofeedback to at follow up; P<0.05) and laxative use (from 29 to 5 percent; P<0.05) were also decreased. Normal spontaneous bowel movement was increased from 52 percent, at pre-biofeedback to 86 percent, at post- biofeedback (P<0.05), 95 percent at follow up (P<0.005). Low bowel frequency, at pre-biofeedback (P<0.01), and hard stool (P<0.05) predicted poor outcome. Long puborectalis length during push (P<0.05) and dynamic descent (P<0.05) on defecography also predicted poor outcome. Low electrical activities of puborectalis and anal sphincter muscle during rest (P<0.001), squeeze (P<0.01) and push (P<0.005) on pre-biofeedback electromyography were related to poor outcome. No patient developed full rectal prolapse during follow up.
CONCLUSIONS
Biofeedback is an effective option and should be considered as the first line therapy especially for patients that don't have low bowel frequency, long puborectalis during push, and dynamic descent before treatment.

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

Physiologic Characteristics and its Clinical Significances in the Patients with Pelvic Outlet Obstruction.: Park, Ung Chae , Chung, Soon Sup , Park, Seung Hwa; J Korean Soc Coloproctol. 2000;16(4):215-222.

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Abstract PDF: Current study was designed to assess the functional etiology of patients with pelvic outlet obstruction. Moreover, physiologic characteristics and theirs clinical significances were evaluated in the patients with ramified diagnosis.
METHODS
172 patients with pelvic outlet obstruction were performed 328 numbers of physiologic studies. These included cinedefecography (n=172), anal manometry (n=87), colonic transit time study (n=38), and anal EMG/PNTML (n=31). On the basis of physiologic findings, patient groups were categorized as rectocele (group I), nonrelaxing puborectalis syndrome (group II), anal dyschezia (group III), and rectoanal intussusception (group IV). The physiologic findings were compared between subgroup patients.
RESULTS
Incidence of categorized patients was 51.7% (group I, n=89), 22.7% (group II, n=39), 12.2% (group III, n=21), and 8.7% (group IV, n=15), respectively. The mean age of patients with group III were lower (p<0.05) than that of overall patients. The incidence of female patients was higher in group I and the incidence of male patients was higher in group II (p<0.0001). In cinedefecography, patients with group II showed smaller anorectal angle at strain (p<0.001), at dynamic change between rest and strain (p=0.002). In anal manometry, patients with group III showed higher mean resting pressures (p=0.001), higher maximum resting pressures (p<0.001), higher mean squeeze pressures, and higher maximal voluntary contraction (p=0.003) than those of patients with other group. In neurologic study, mean value of PNTML was 2.32 +/- 0.34 (range, 1.60~3.66) msec in overall patients. The size of rectocele was increased in proportion to patient's age (r=0.229, p<0.05), number of delivery (r=0.393, p=0.001), and degree of perineal descent (r=0.231, p<0.05). The degree of perineal descent was increased in proportion to patient's age (r=0.249, p<0.05).
CONCLUSIONS
Present series provided the diagnostic ramification of pelvic outlet obstruction by using the anorectal physiologic investigations. In addition to the function of puborectalis muscle, evacuation dynamics of anorectum should be emphasized. These findings could provide the fundamental information for guideline of future therapy in the patients with obstructed defecation.

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.

Case Reports

A Case Report of Colorectoanal Intussusception.: Lee, Sang Jeon , Park, Jin Woo; J Korean Soc Coloproctol. 1998;14(2):305-308.

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Abstract PDF: Colorectoanal intussusception is a rare and distinct entity that differs from the more common rectal prolapse. Typically the intussusception occurrs with tumor at the apex of the intussuscepted segment acting as lead point. Here we present a case and review the literature of colorectoanal intussusception. The case presented here is that of an elderly woman with a proximal sigmoid colon cancer at its apex. Anterior resection was electively performed after reduction of the intussusception. It is important to differentiate a colorectoanal intussusception from the more common rectal prolapse because treatment may differ. The anorectum remains in its normal anatomic position in colorectoanal intussusception, whereas the anal canal is effaced with the prolapsed segment of bowel in rectal prolapse. Identification of a tumor at the apex of the intussuscepted bowel should also arouse suspicion that the condition is not a rectal prolapse.

A Case Report of Intussusception of the Vermiform Appendix with Adenocarcinoma.: Yoon, Dae Sung , Lee, Jae Jung , Park, Chul Jae , Kim, Duck Hwan; J Korean Soc Coloproctol. 1998;14(1):143-148.

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Abstract PDF: The authors present a case of intussusception of the vermiform appendix with ade nocarcinoma. A 35-year-old male with lower abdominal pain and anemia was found to have an intussusception of the appendix associated with an adenocarcino-ma. The preoperative diagnosis was cecal cancer but we detected the iutussuscept-ion of the appendix with an adenocarcinoma during operation. Patient was managed with right hemicolectomy and has been followed up.

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