Colocolonic intussusception identified during endoscopy: an incidental diagnosis

A 42-year-old man with no prior medical history presented with perianal pain and pustular drainage over the course of 1 week. On physical examination, he had a perianal abscess with a draining sinus tract, but no abdominal tenderness to palpation. Laboratory tests showed severe iron deficiency anemia. As part of a workup for this, an upper gastrointestinal endoscopy was performed, which was unremarkable. Subsequently, a colonoscopy was performed, which revealed no mucosal inflammation but did show a large focal region of the mid-transverse colon, which spontaneously protruded and retracted ([Video 1]). To evaluate this further, a computed tomography (CT) scan was performed, which revealed a colocolonic intussusception of the transverse colon, without any focal neoplasm ([Fig. 1]). The patient’s perianal abscess improved on antibiotics without the development of any further symptoms and he was discharged home.

Video 1 Endoscopy showing a colocolonic intussusception of a focal region of the mid-transverse colon.

Fig. 1 Coronal oral and intravenous contrast-enhanced computed tomography (CT) image displaying a colocolonic intussusception (arrow).

Colocolonic intussusception is a rare finding and is usually associated with malignancy in adults, but can also occur spontaneously [1]. About 20 % of such cases are transient or asymptomatic in adults and may not necessitate surgical intervention [2]. Abdominal CT can accurately diagnose intussusception in approximately 78 % of patients; findings typically include a target-like or sausage-shaped mass with a layering effect [3] [4]. Endoscopy provides invaluable information through direct visualization in order to precisely determine the lead point, as demonstrated by this case.

Endoscopy_UCTN_Code_CCL_1AD_2AJ

Competing interests

The authors declare that they have no conflict of interest.

• References

• 1 Marinis M, Yiallourou A, Samanides L. et al. Intussusception of the bowel in adults: a review. World J Gastroenterol 2009; 15: 407-411
• 2 Tanabe T, Furukawa S, Masuda T. et al. Asymptomatic colonic intussusception in ulcerative colitis: a case report. J Sur Case Rep 2020; 2020: rjaa050
• 3 Azar T, Berger DL. Adult intussusception. Ann Surg 1997; 226: 134-138
• 4 Kim YH, Blake MA, Harisinghani MG. et al. Adult intestinal intussusception: CT appearances and identification of a causative lead point. Radiographics 2006; 26: 733-744

Publication History

Article published online:
10 March 2022