A Case of Intussusception Prolapsing through the Anus Caused by Sigmoid Colon Cancer Diagnosed by Intraoperative Colonoscopy

Abstract

An 87-year-old woman presented with abdominal pain and bloody stool. A plain abdominal CT scan showed a multi-layered intussusception structure from the sigmoid colon to the rectum. The prolapsed colon through the anus was identified, but no tumor which might lead the intussusception was obvious on inspection. Because endoscopic reduction was impossible, the patient was referred to our department with a view to surgery. We performed emergently open reduction of the intussusception after pushing back the relapsed colon by hand through the anus. Intraoperative colonoscopy revealed a type 2 tumor in the sigmoid colon, and suggested that the distal intestine might be necrotic and congested. Sigmoidectomy was performed along with the resection of the necrotic intestine. Histopathology demonstrated that the type 2 tumor was sigmoid colon carcinoma and the distal bowel was necrotic. Postoperative course was uneventful and the patient currently survives without having any recurrent tumor.

We experienced an adult patient with intussusception prolapsing through the anus, who was diagnosed with sigmoid colon cancer by intraoperative colonoscopy. We present the case together with a review of the literature.