A Case of Colocolic Intussusception Caused by a Juvenile Polyp and Treated With Nonoperative Reduction Followed by Endoscopic Resection

Abstract

Intussusception is a major pediatric emergency. Unlike the majority of cases, which are of the idiopathic ileocolic type, the colocolic type is often associated with a pathological lead point. We report a case of colocolic intussusception where a juvenile polyp was endoscopically resected following successful nonoperative reduction. The patient was a 7-year-old boy who presented to the emergency department with chief complaints of abdominal pain and vomiting. Abdominal ultrasound and computed tomography (CT) led to a diagnosis of colocolic intussusception. Nonoperative reduction with a hydrostatic enema was successfully performed, resulting in the complete resolution of the intussusception. Although no contrast findings suggestive of a pathological lead point were observed, a subsequent lower gastrointestinal endoscopy was performed for confirmation. This examination identified a polypoid lesion suspected to be the pathological lead point, which was then resected endoscopically. In cases of colocolic intussusception, nonoperative reduction is recommended as the initial treatment, similar to general intussusception. However, even after reduction, the possibility of a pathological lead point must be considered. Therefore, early investigation by lower gastrointestinal endoscopy and proactive therapeutic intervention are necessary.