Colo-colic Intussusception on a Coecal Tumour: A Case Report

Abstract

Introduction: Adult intussusception is a rare clinical condition (1) and about 70%-90% of adult intussusception cases (2). The principle causes are benign or malignant tumors. In adults, the most frequent localizations of intestinal invaginations are the ileo-cecal segment, ileum and colon as exclusive localization (3). the diagnostic and therapeutic methods must be adapted to each case (4).. We report a case of cecal-colonic intussusception treated surgically and review the characteristics and treatment of colonic intussusceptions in the literature. Materials and Methods: Our work is a retrospective case report with a descriptive aim concerning a patient operated for a colonic intussusception within the department of general surgery of CHU Ibn Rochd Casablanca. Case Report: A 61-year-old woman presented to the department with diffuse abdominal pain evolving for 4 months with alternating constipation and diarrheal debacle, without externalized digestive hemorrhage, all evolving in a context of apyrexia and alteration of general condition. On physical examination, the patient was conscious and stable on the respiratory and hemodynamic level and abdominal examination found a generalized abdominal tenderness without palpable mass. The abdominal CT scan showed an aspect of ileocolic intestinal invagination on a tumor-like thickening of the right colon wall measuring 2.5 cm, extended to the right colonic angle. It also showed that the right kidney was in a pelvic ectopic position. The operation was performed by laparotomy through a median incision. On exploration, we found an intussusception of the cecum at the level of the ascending colon on a cecal tumor of 5 cm, it was therefore a cecal-colic intussusception. The intervention consisted of a right ileo-hemicolectomy removing a cecal-colic intussusception with terminal ileo-colic anastomosis by separate stitches and with retro-anastomotic drainage and of the parieto-colic gutter. Conclusion: Colonic intussusception is a rare cause of obstruction in the adult and its preoperative diagnosis remains difficult. Surgery remains the mainstay of treatment.