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Intussusception due to carcinoma of the sigmoid colon in an adult report of a case diagnosed by colonoscopy



Intussusception due to carcinoma of the sigmoid colon in an adult report of a case diagnosed by colonoscopy



Gastroenterological Endoscopy 31(9): 2519-2523



Intussusception in adult is known as a rare condition, and to the best of our knowledge, there are only 12 case reports in Japanese literature that adult intussusception was observed by endoscope preoperatively. A 75-year-old male visited the clinic of our hospital with melena of four week's duration. Rectal examination revealed a soft mass. Colonoscopic examination disclosed a large smooth surfaced tumor, which simulated a submucosal tumor, and an irregular polypoid lesion at the base of the tumor. The diagnosis of this polypoid lesion by means of endoscopic biopsy was adenocarcinoma. A barium enema carried out after admission disclosed that the smooth surface mucosa of the large tumor was related to intussusception of the colon. Operation was performed. The polypoid lesion was 32 .times. 28 .times. 9 mm in size and pathologically diagnosed as well differentiated adenocarcinoma in which the depth of cancerous invasion was pm. It is a generally accepted opinion that intussusception in adult usually occurs secondarily to pre-existing neoplasms, and that most of the cases had a protracted clinical course prior to operation. Therefore, colonoscopy should be performed actively to make a correct preoperative diagnosis of the causative lesion.

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