Sigmoidorectal intussusception in adults: a case report
di
M. Assenza, G. Ricci, A. Antoniozzi, V. Martines, L. Valesini, V. Romeo, C. Modini
A 75-year-old women was admitted to our hospital due to anal
bleeding from 5 days. At clinical examination abdomen was soft but
tenderness in the lower quadrants, where a soft, mobile, round mass
measuring 10 cm in diameter was palpable. CT scan demonstrated the
presence of sigmoido-rectal intussusception. The patient underwent
emergency anterior resection of rectum with stapled termino-terminal
colo-rectal anastomosis. Postoperative course was uneventful and the
patient was discharged 7 days after the operation. Histopathological
examination demonstrated a tubular adenoma with low grade dysplasia,
1,2 cm in diameter, located in the distal sigmoid colon.
Intussusception is a rather common pediatric condition that rarely
presents in adults. Adults intussusception represents 5% of all cases
of intussusception. In children it is usually primary and benign, and
pneumatic or hydrostatic reduction of the intussusception is suffi cient
to treat the condition in 80% of patients. In contrast a demonstrable
etiology is found in 70% to 90% of cases in adults, and approximately
40%-50% of them are caused by malignant neoplasms. Surgical intervention
is necessary in all cases of intussusception in adults. Due
to the low incidence and the rare consideration given to this condition
among adults the preoperative diagnosis can be diffi cult, especially in
emergency cases. Abdominal CT provides the most accurate diagnostic
rate for intestinal intussusception. Clin Ter 2010; 161(1):65-67
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