2004 Volume 37 Issue 4 Pages 452-457
Adult intussusception in the large intestine is often headed by a malignant lesion, but the intussusception prolapsing through the anus with sigmoid cancer is rare, only 27 cases have been reported in Japan. In this paper, we present 2 cases of this desease. Case 1 was a 90-year-old woman with dyschezia and lower abdominal pain. The prolapsed colon with a tumor located at the apex through the anuswas seen during defecation. Preoperative examinations including colonoscopy and a gastrografin enema study were done. Case 2 was an 84-year-old woman with lowerabdominal pain and a prolapsed colon through the anus. Pre-operative examinations including pelvic computed tomography (CT) were done. In both cases, sigmoidectomy with lymph node dissection (D2) was performed after manual reduction of the intussusception. It is controvertial wheather preoperative manual reduction of the intussusception should be performed or not. But in our cases, preoperative manual reduction of the intussusception seemed to be plactical. On the other hand, it should be considered to select less invasive transanal colorectomy for an oldperson with some complication.
