Colorectal Intussusception Due to Rectosigmoid Junction Cancer: A Unique Surgical Challenge?

Excerpt

Intussusception is a rare clinical entity in adults whereas in pediatric population is an emergency commonly seen. It is found in less than 1 in 1300 abdominal operations and the adult to child ratio is 1:20 [1]. Intussusception describes the condition in which a proximal segment called “intussusceptum” telescopes into the lumen of the adjacent distal segment of the gastrointestinal tract called “intussuscipiens.” Adult intussusception represents 1–5% of all bowel obstructions and 5% of intussusceptions [2]. The condition is distinct from pediatric intussusception in various aspects. In children, it is primary and idiopathic, and pneumatic or hydrostatic reduction is sufficient to treat the condition in 80% of cases. On the other hand, in adults, a lead point is common in 90% [3]. The exact mechanism is still unknown, but the most possible explanation is impaired peristalsis in combination with any lesion in the bowel wall, which leads to obstruction of the intestinal lumen and mesenteric vascular flow, driving into ischemia and perforation [4‐6]. Most lead points in the small bowel are benign lesions with a percentage of 66%, while in the large bowel, the percentage of malignant and benign lesions is 70% and 30%, respectively [7‐10]. The majority of lesions in colon are mostly adenocarcinomas, lipomas, and inflammatory diseases [10, 11]. Intussusception is classified as entero-enteric, ileocolic, ileocecal, and colocolic-colorectal [3, 8]. …