A case of perforation of the colon distal to the head of intussusception caused by transverse colon cancer

Abstract

Intussusception in an adult is rare and the cause of peritonitis caused by perforation of the colon with intussusception is further rare. We experienced such a rare case and report it here. The patient was a 56-year-old male admitted in a hospital in Dec. 2007 with the chief complaint of abdominal pain. On the 12^th day of admission flat plate of abdomen revealed free air and a diagnosis of bowel perforation was made and the patient was referred to our hospital. When he came to the hospital the consciousness was clear and there was tenderness and some muscle rigidity of the abdomen. Abdominal CT study revealed a perforation of the colon caused by an intussusception of the transverse colon cancer resulting in peritonitis. An emergent operation was performed on the same day, and a perforation of the transverse colon 5cm in diameter towards the splenic flexure was found, and a type II cancer, about 10cm in size was seen exposed into the abdominal cavity from the perforation. Dilatation and edema of the proximal intestine was significant and the nutritional state of the patient was poor, so instead of intestinal anastomosis, simple resection of the ascending, transverse and descending colon and D1 lymph node dissection, ileostomy and drainage of the abdominal cavity were performed. The postoperative course was uneventful and the patient was transferred to the previous hospital without problems.