Descending colo-colonic intussusception due to adenocarcinoma

Case contributed by Dr Chris O'Donnell

Presentation

PH of spinal surgery with development of paraparesis. Neurogenic bladder. Abdominal distension with melaena.

Patient Data

Age: 55
Gender: Male

Typical features of intussusception involving the left hmeicolon producing a colied 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 caecum. 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.

Case Discussion

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.

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Case information

rID: 42768
Case created: 7th Feb 2016
Last edited: 9th Feb 2016
Inclusion in quiz mode: Included

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