抄録
A 90-years-old woman was admitted to our hospital with a prolapsing tumor through the anus. The tumor caused intussusception of the colon and drew the rectum and sigmoid colon out of the anus. A trans-anal resection of the tumor was performed, however, the intussusception of the sigmoid colon could not be reversed completely. We attempted colonoscopic repositioning of the intussusception by applying pressure with air and water through the colonoscope and by pushing the colonoscope directly into the region of the intussusception, however, these procedures were not effective because the force for the repositioning was lost through the lumen of the intussuscepted intestine. Therfore, we joined a balloon catheter to the head of the colonoscope in order to catch the intussuscepted lumen and pushed the colonoscope to achieve repositioning of the intussusception.
After repositioning of the intussusception, ALTA was injected via the colonoscope below the region of the intussusception. The tumor was diagnosed pathologically as a villous adenoma with moderate atypia. The intussusception and prolapse have not recurred until date after the operation. Therefore, for intussusception with prolapse of the lower colon due to a tumor in older patients, such as in our case, the combination of trans-anal operation and the colonoscopic repositioning procedure may be suitable because of the low invasiveness.
