Presentation
Lower abdominal pain for the last 3 days
Patient Data
Intusussception of the distal descending colon and proximal sigmoid colon with its mesentery into a thickened distal sigmoid colon and rectum. An enhancing, irregularly-shaped polypoidal mass is seen at its leadpoint within the rectum, measuring 28 x 27 x 30 mm in dimensions. The rectal wall is noted to be thickened by up to 15 mm. Proximal to the intussusception, the colon is significantly faecally loaded. No dilated loop of bowel seen proximally.
No discrete fluid collection. No pockets of extraluminal gas suggestive of perforation.
No obvious perirectal adenopathy.
A flexible sigmoidoscopy verified the presence of a mass as the leadpoint of the intussusception, which was suspicious for malignancy. Left-sided hemicolectomy was then performed.
Case Discussion
The sigmoid colon is an uncommon site for large bowel intussusception. In adults, colocolic intussuseption is most commonly due to a malignancy acting as a leadpoint.
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