Colocolonic intussusception in an adult secondary to an inflammatory polyp of the transverse colon - clinical case

Authors

  • Luis A. Falcón-Cancino Department of General Surgery, Clínica Hospital Mérida-APP del ISSSTE, Facultad de Medicina - Universidad Autónoma de Yucatán, Mérida, Yucatán, México
  • Raúl Obregón-Patiño Department of General Surgery, General Hospital of Playa Del Carmen, Solidaridad, Quintana Roo, México
  • Jessica Barbosa-Guerrero Department of General Surgery, General Hospital of Playa Del Carmen, Solidaridad, Quintana Roo, México
  • Alejandro A. Flores-López Department of General Surgery, Clínica Hospital Mérida-APP del ISSSTE, Facultad de Medicina - Universidad Autónoma de Yucatán, Mérida, Yucatán, México
  • Luis A. Agustín-Martínez Department of General Surgery, Clínica Hospital Mérida-APP del ISSSTE, Facultad de Medicina - Universidad Autónoma de Yucatán, Mérida, Yucatán, México
  • Segundo Yépez-Vallejo Department of General Surgery, General Hospital of Playa Del Carmen, Solidaridad, Quintana Roo, México
  • Fidel Echevarría-Fernández Department of General Surgery, General Hospital of Playa Del Carmen, Solidaridad, Quintana Roo, México
  • Guillermo Padrón-Arredondo Department of General Surgery, General Hospital of Playa Del Carmen, Solidaridad, Quintana Roo, México
  • Alejandro L. Villalobos-Rodríguez Department of Gynecology and Obstetrics, General Hospital of Playa Del Carmen, Solidaridad, Quintana Roo, México

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230886

Keywords:

Adult, Intussusception, Colonic polyp, Upper abdominal pain, Ultrasound

Abstract

There are multiple causes of colocolonic intussusception in adults, such as tumors, autoimmune pathologies, previous abdominal surgeries, and gynecological conditions. Associated complications are small bowel obstruction, ischemia, necrosis, perforation with peritonitis, and sepsis that require urgent attention. A 78-year-old woman who started with colic in the mesogastrium of 5 months of evolution and changes in bowel habits. She went to the emergency room due to intense pain in the mesogastrium. On physical examination, she presented dehydration of the mucous membranes and pale integuments, pain on superficial and deep palpation in the mesogastrium. Admission laboratories: leukocytosis 17,110/ul, neutrophilia 67.9%, hydroelectrolyte imbalance: mild hyponatremia, mild hypochloremia, slightly prolonged coagulation times, normal blood chemistry. Abdominal ultrasound with "pseudokidney" image. Computed tomography reports an image of the introduction of a segment of the transverse colon into a contiguous segment of the same, with data of associated intestinal pneumatosis. Due to the previous findings, an emergency exploratory laparotomy was performed. Invagination of the transverse colon is located, accompanied by dilation of the vessels of the greater omentum; it is reduced manually, an enterotomy is performed and a tumor dependent on the wall is located, for which a 25 cm transverse colon resection, end colostomy and mucous fistula are decided. Pathology report reports inflammatory polyp. In the postoperative period, the patient improved and was discharged. Abdominal pain is the common presentation of intussusception; however, given its rarity in adults, the possibility of missing the finding on abdominal imaging leads to misdiagnosis.

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Published

2023-03-29

How to Cite

Falcón-Cancino, L. A., Obregón-Patiño, R., Barbosa-Guerrero, J., Flores-López, A. A., Agustín-Martínez, L. A., Yépez-Vallejo, S., Echevarría-Fernández, F., Padrón-Arredondo, G., & Villalobos-Rodríguez, A. L. (2023). Colocolonic intussusception in an adult secondary to an inflammatory polyp of the transverse colon - clinical case. International Journal of Research in Medical Sciences, 11(4), 1338–1342. https://doi.org/10.18203/2320-6012.ijrms20230886

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Section

Case Reports