Case of Colocolic Intussusception Caused by Poorly Differentiated Colonic Adenocarcinoma in an Elderly Patient

Abstract

Introduction: Intussusception, the telescoping of one segment of the intestine into an adjacent portion, is a rare surgical emergency in adults, primarily linked to tumoral processes.  The rarity and severity of this condition warrant timely surgical intervention, while the imprecise clinical symptoms often lead to misdiagnosis. Case Presentation: A 58-year-old male patient sought medical attention for persistent abdominal pain and distention over the preceding 2 months. Physical examination revealed a palpable, non-tender, 6x4 cm lump extending up to the epigastrium. Radiological investigations unveiled a 7x6x4 cm soft tissue mass located in the middle third of the transverse colon, causing luminal constriction and stranding of the transverse mesocolon. These findings strongly suggested a neoplastic origin. Additionally, a 7 cm long colo-colic intussusception was identified, with the mass serving as the leading point. Subsequent histopathological examination of the surgical specimen confirmed the presence of a poorly differentiated colonic adenocarcinoma. Clinical Discussion: Adult intestinal intussusception differs significantly from its pediatric counterpart and presents a diagnostic challenge due to its vague clinical manifestations. Consequently, it is frequently mistaken for other causes of intestinal obstruction and are also known to trigger colo-colic intussusception. Conclusion: This case underscores the importance of recognizing that intussusception can manifest as a surgical emergency, even in elderly patients, necessitating swift surgical intervention to prevent intestinal ischemia and gangrene. The rarity of adult intussusception, especially when associated with colonic adenocarcinoma, necessitates heightened awareness among clinicians and underscores the urgency of appropriate management.