Colo-colic Intussusception on a Coecal Tumour: A Case Report
Published: 2021-08-20
Page: 581-585
Issue: 2021 - Volume 4 [Issue 2]
Asmaa El-Karouachi
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
Ahmed Elmi Abdirahim *
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
Zouhair Abdeladim
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
Bouali Mounir
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
El Bakouri Abdelilah
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
Bensardi Fatima-zahra
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
El hattabi Khalid
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
Fadil Abdelaziz
Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Adult intussusception is a rare clinical condition (1) and about 70%-90% of adult intussusception cases (2). The principle causes are benign or malignant tumors. In adults, the most frequent localizations of intestinal invaginations are the ileo-cecal segment, ileum and colon as exclusive localization (3). the diagnostic and therapeutic methods must be adapted to each case (4).. We report a case of cecal-colonic intussusception treated surgically and review the characteristics and treatment of colonic intussusceptions in the literature.
Materials and Methods: Our work is a retrospective case report with a descriptive aim concerning a patient operated for a colonic intussusception within the department of general surgery of CHU Ibn Rochd Casablanca.
Case Report: A 61-year-old woman presented to the department with diffuse abdominal pain evolving for 4 months with alternating constipation and diarrheal debacle, without externalized digestive hemorrhage, all evolving in a context of apyrexia and alteration of general condition. On physical examination, the patient was conscious and stable on the respiratory and hemodynamic level and abdominal examination found a generalized abdominal tenderness without palpable mass. The abdominal CT scan showed an aspect of ileocolic intestinal invagination on a tumor-like thickening of the right colon wall measuring 2.5 cm, extended to the right colonic angle. It also showed that the right kidney was in a pelvic ectopic position. The operation was performed by laparotomy through a median incision. On exploration, we found an intussusception of the cecum at the level of the ascending colon on a cecal tumor of 5 cm, it was therefore a cecal-colic intussusception. The intervention consisted of a right ileo-hemicolectomy removing a cecal-colic intussusception with terminal ileo-colic anastomosis by separate stitches and with retro-anastomotic drainage and of the parieto-colic gutter.
Conclusion: Colonic intussusception is a rare cause of obstruction in the adult and its preoperative diagnosis remains difficult. Surgery remains the mainstay of treatment.
Keywords: Intussusception, coecum, right colon, anastomosis