Intussusception in an adult after colonoscopy

Colonic intussusception after endoscopic mucosal resection successfully managed by endoscopic procedure

Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.

Intussusception after colonoscopic polypectomy: a rare complication

We present a patient who developed an ileocolic intussusception within a few hours of undergoing an endoscopic polypectomy found on screening colonoscopy. She underwent a laparoscopic right hemicolectomy with intracorporeal anastomosis. Final histopathological examination showed no evidence of malignancy. Intussusception after colonoscopy is a rare complication, and only 11 cases have been reported prior to this case. Laparoscopic resection with intracorporeal anastomosis is a safe and feasible option in patients who are not candidates or failed conservative management.

OUP accepted manuscript

The incidence of complications after colonoscopy is low and has been reported to range of 0.01–0.9%. Of these complications, colocolonic intussusception after colonoscopy is exceedingly rare, with around 12 known cases described in the literature. This case report details the presentation and operative management of a patient who developed an ischemic stoma due to a colocolonic intussusception of an end colostomy after a colonoscopy. Intraoperative surgical exploration revealed a colocolonic intussusception involving the end colostomy. This is the first known documented occurrence of this phenomenon.

Intussusception in a Routine Colonoscopy

We present a 42-year-old woman who developed colo-colonic intussusception of the transverse colon near the hepatic flexure within a few hours after a routine colonoscopy. After conservative management with pain medication and hydration, her symptoms completely resolved within 24 hours. Colonic intussusception after a colonoscopy is rare, and the present case describes the most conservative approach leading to a complete resolution of symptoms.

Early Postendoscopic Transverse Colo-Colonic Intussusception

Intussusception is defined as telescoping of the proximal bowel (intussusceptum) into the lumen of the distal bowel, otherwise called the intussuscipiens. While it is one of the most common causes of intestinal obstruction in children between the ages of 3 months and 6 years, intussusception accounts for about 1% of such cases in adults. Intussusception is idiopathic in 8–20% of patients and most commonly occurs in the small intestines in adults. We describe the unique case of a colo-colonic intussusception in a 54-year-old female patient 1 week after a colonoscopy for suspected inflammatory bowel disease. The discussion focuses on the presentation and management options of intussusception.

Intussusception after Colonoscopy: A Case Report and Review of Literature

Intussusception after colonoscopy is an unusual complication. A MEDLINE search revealed only 7 reported cases. We present a report of a 28-year-old man who developed abdominal pain several hours after routine colonoscopy and in whom computed tomography (CT) revealed colocolic intussusception. We postulate that this condition is iatrogenic and induced by suctioning of gas on withdrawal of the colonoscope. A common observation among the reported cases was abdominal pain several hours after colonoscopy and right-sided intussusception. All cases had colonoscopy reaching the right side of the colon. Treatment for adult intussusception remains controversial with regard to reduction versus resection, especially given the high association with a pathological cause and malignancy. Among the 8 reported cases, only the current case did not require surgery. A combination of benign colonoscopy, CT, and the clinical picture should provide sufficient information to initially choose a more conservative treatment approach.

Intussusception after Routine Colonoscopy: A Rare Complication

We present a 31-year-old woman who developed ascending colon intussusception several hours after a routine colonoscopy where random mucosal biopsies were obtained. She underwent an ileocolic resection, and pathology did not show an etiology for the intussusception. Colonic intussusception occuring without pathology and after minimal intervention is rare.

Ileocolic intussusception precipitated by diagnostic colonoscopy: a case report

Only 5% of all cases of intussusceptions occur in adults. Intussusception complicating colonoscopy is an extremely rare event. Herein, we present a case of a 58-year-old man who developed ileocolic intussusception after a colonoscopy during which an adenomatous polyp was discovered in the terminal ileum. Eight hours after colonoscopy, the patient developed diffuse abdominal pain associated with vomiting and bloody diarrhea. A contrast-enhanced abdominal computed tomography scan revealed features of mechanical intestinal obstruction and a round soft tissue mass inside the right colon, followed by the wall of the intussusceptum. Emergency laparotomy revealed extended ileocecal intussusception with the polyp incarcerated by the ileocecal valve. A typical right hemicolectomy was performed, and the patient had an uneventful recovery. Histologic examination of the surgical specimen revealed an inflammatory fibroid polyp. Ileocolic intussusception due to an ileal polyp may be precipitated by colonoscopy and should be included in the differential diagnosis of acute abdomen after colonoscopy.

Colonoscopy Leads to A Diagnosis of A Jejunal Gastrointestinal Stromal Tumour (GIST)

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal (GI) tract, but are the least common of small intestinal malignant neoplasms. While GI bleeding is the most common clinical presentation of GISTs, intussusception and obstruction are uncommon, as GISTs rarely grow into the lumen. We describe an unusual case of a 50-year-old male who presented with intermittent obscure, overt GI bleeding requiring multiple hospital admissions and blood transfusions. His work-up included abdominal CT imaging, small bowel follow-through, gastroscopies, push enteroscopy, colonoscopies, and anterograde and retrograde double-balloon enteroscopies. Complicating his presentation were colonic angiodysplasias and the development of recurrent venous thromboembolism requiring anticoagulation. Within an hour after an apparently uncomplicated colonoscopy, he developed an acute abdomen secondary to a jejunal intussusception, which led to a laparoscopic small bowel resection and the diagnosis of a jejunal GIST. Given his GIST had no high-risk features, ongoing surveillance with abdominal CT imaging was arranged. This case illustrates the complex presentation and diagnostic difficulty of a jejunal GIST causing obscure, overt GI bleeding and this is the first reported case of a jejunal intussusception following colonoscopy. Due to its submucosal location, multiple endoscopic approaches had failed to diagnose the GIST prior to surgery.

Post Colonoscopy Colonic Intussusception Reduced via a Laparoscopic Approach

The authors discuss a case of colon intussusception following colonoscopy successfully treated by laparoscopic reduction.

Intussusception occurs when a mass in the bowel is pulled forward by normal peristalsis, with resultant invagination of the involved bowel wall. In the absence of a mass, intussusception may be caused by functional disturbances without gross mural abnormality. Colo-colonic intussusception in adult is relatively rare and usually secondary to a definable lesion, the majority of which are malignant in nature. Idiopathic intussusception in adults is rare and its pathogenesis is poorly understood.

We present a case report of an adult colo-colonic intussusception occurring after colonoscopy, which was treated successfully with laparoscopic reduction. We speculate that the intussusception was induced by post-polypectomy mucosal edema acting as a lead point and therefore can be treated without resection.

Small bowel obstruction complicating colonoscopy: a case report

Introduction

This report describes a rare complication of colonoscopy and reviews the literature with regard to other rare causes of acute abdominal presentations following colonoscopy.

Case presentation

After a therapeutic colonoscopy a 60-year-old woman developed an acute abdomen. At laparotomy she was discovered to have small bowel obstruction secondary to incarceration through a congenital band adhesion.

Conclusion

Although there is no practical way in which such rare complications can be predicted, this case report emphasises the wide array of pathologies that can result in acute abdominal symptoms following colonoscopy.

[Intestinal invagination after vagotomy in adults]

Intestinal intussusception is a rare condition in adults. In most cases, it is caused by a benign or malignant intestinal tumor. Primitive forms are infrequent, and their occurrence following troncular vagotomoy has never been described in the literature, according to our knowledge. Two cases of post-vagotomy jejuno-jejunal intussusception are reported.