Case reports of adult colo-colonic intussusception

Abstract

Background: Adult colo-colonic intussusception is a rare abnormality and it may pose a diagnostic challenge Objective: To report two cases of adult colo-colonic intussusception with benign lesion as the lead points. Methods: The Clinical records of the two patients containing the management details were retrieved and reviewed. Results: The 1st case was a 60 year old man presenting with a year history of recurrent left abdominal pain a two week history of fullness left upper and lower abdomen. Examination showed an 8cm by 6cm mass in the left hypochondrium continuing with another 16cm by 8cm mass spanning the left lumbar and left iliac fossa. Abdominal ultrasound scan showed a huge mixed echogenic mass in the central abdomen spanning the left hypochondriac, left lumber and suprapubic regions. He had exploratory laparotomy which revealed colo-colonic intussusception involving the ascending colon up to sigmoid colon. He had subtotal colectomy done. The lead point was a hamartomatous polyp The 2nd case was a 35 year old man with a two month history of recurrent abdominal pain and haematochezia, a month history change in bowel habit and five day history of abdominal distension. Examination showed distended abdomen with generalised tenderness. There was a firm mass in the left hypochondrium extending to the left iliac fossa. Abdominal ultrasound scan confirm intussusception. Exploratory laparotomy showed perforation of transverse colon at the neck of colo colonic intussusception involving the distal third of the transverse colon to the rectum. He had extended left hemicolectomy and Devine colostomy done. He died 36 hours post operation. The lead point was an inflammatory polyp. Conclusion: Adult colo-colonic intussusception is an uncommon disease which may not present in a typical feature of intussusception as occur in children thus posing diagnostic dilemma. High index of suspicion