Journal Information
Vol. 84. Issue 4.
Pages 513-514 (October - December 2019)
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272
Vol. 84. Issue 4.
Pages 513-514 (October - December 2019)
Clinical image in Gastroenterology
DOI: 10.1016/j.rgmxen.2019.09.002
Open Access
Sigmoidorectal intussusception as the first manifestation of colonic neoplasia
La intususcepción del colon sigmoide como primera manifestación de neoplasia de colon
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272
M. Patitaa,
Corresponding author
martapatita21@gmail.com

Corresponding author at: Departamento de Gastroenterología, Hospital Garcia de Orta, Av. Torrado da Silva, 2805-267, Almada, Portugal.
, G. Nunesa, V. Fernandesa,b
a Departamento de Gastroenterología, Hospital Garcia de Orta, Almada, Portugal
b Departamento de Gastroenterología, CUF Clínica Almada, Almada, Portugal
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A 92-year-old woman was admitted to the hospital due to hematochezia persisting for 5 days. Anorectal inspection revealed complete rectal prolapse (Fig. 1), with an irregular polypoid neoplasm at the distal end, which was considered the lead point for the prolapse. Manual reduction of the prolapse was easily performed through the anus, but endoscopy revealed a colocolic intussusception that prevented identification of the lumen and scope progression (Fig. 2). To complete the colonoscopy, the prolapse was externalized again and digital examination enabled the identification of the lumen adjacent to the pedicle of the lesion. Prolapse and invagination were simultaneously resolved after scope reintroduction (Fig. 3). Synchronous lesions were ruled out and the pathology study confirmed the diagnosis of adenocarcinoma.

Fig. 1.

Complete rectal prolapse with an irregular polypoid neoplasm at the distal end.

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Fig. 2.

Colonoscopy performed after rectal prolapse reduction, identifying colonic intussusception. It was not possible to distinguish the lumen.

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Fig. 3.

Introduction of the colonoscope adjacent to the vegetative lesion, where the lumen was identified in the exteriorized prolapse.

(0.09MB).

Sigmoidorectal intussusception mimicking rectal prolapse is extremely rare in adults.1,2 The present case is an example of the need to consider colorectal cancer in such a clinical setting,2,3 and how a simple approach can be used to temporarily resolve the intussusception, preventing mucosal ischemia and the risks associated with urgent surgery.

Ethical considerations

The authors declare that no experiments were conducted on humans or animals in relation to the present case and that they followed the protocols of their work center on the publication of patient data, maintaining patient anonymity at all times. The corresponding author has the statement of informed consent. The study protocol was approved by the ethics committee of theHospital García de Orta.

Financial disclosure

No financial support was received in relation to this article.

Conflict of interest

The authors declare that there is no conflict of interests.

References
[1]
A. Wilson, G. Elias, R. Dupiton.
Adult colocolic intussusception and literature review.
Case Rep Gastroenterol, 7 (2013), pp. 381-387
[2]
M. Mohamed, K. Elghawy, D. Scholten, et al.
Adult sigmoidorectal intussusception related to colonic lipoma: a rare case report with atypical presentation.
Int J Surg Case Rep, 10 (2015), pp. 134-137
[3]
J.Z. Du, L.T. Teo, M.T. Chiu.
Adult rectosigmoid junction intussusception presenting with rectal prolapse.
Singapore Med J, 56 (2015), pp. e78-81

Please cite this article as: Patita M, Nunes G, Fernandes V. La intususcepción del colon sigmoide como primera manifestación de neoplasia de colon. Revista de Gastroenterología de México. 2019;84:513–514.

Copyright © 2019. Asociación Mexicana de Gastroenterología
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