Descending colo-colonic intussusception due to adenocarcinoma
PH of spinal surgery with development of paraparesis. Neurogenic bladder. Abdominal distension with melena.
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Typical features of intussusception involving the left hemicolon producing coiled spring -like pattern. Note mesenteric vessels to the intussucepted bowel continue to enhance. There is, however, gross proximal large bowel obstruction with marked distension of the cecum. Note markedly thick-walled neurogenic bladder with hydronephrosis.
Rectal gastrografin shows a lobulated mass lesion at the lead point of the intussusception in the sigmoid. The patient had an urgent left hemicolectomy with adenocarcinoma confirmed.
Adult colonic intussusception is rare and descending colon is unusual due to the normal retroperitoneal attachments of the descending colon that should normally prevent such pathology form occurring.