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Late postoperative adult intussusception without tumor related cause: an alternative option in management

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Author(s): I. Pilpilidis | Anthia Gatopoulou | K. Soufleris | A. Tarpagos | I. Katsos

Journal: Annals of Gastroenterology
ISSN 1108-7471

Volume: 19;
Issue: 4;
Date: 2007;
Original page

ABSTRACT
Introduction and Aims: To present a case of late postoperative bowel obstruction with uncommon etiology, that was successfully reduced during endoscopy. Description of a case: We report a case of a 63 year–old man presenting with failure to pass flatus and stool for two days. The patient underwent partial left hemicolectomy due to cancer of the sigmoid colon 5 years ago and an emergency transverse colostomy was performed 2 years ago due to bowel obstruction (megacolon). Six months after colostomy, a diagnostic colonoscopy was performed which revealed a fibrotic stenosis at the site of anastomosis that was corrected performing balloon dilatation. Restoration surgery with closure of colostomy was decided since abdominal computed tomography and laboratory tests confirmed the absence of cancer recurrence. A preoperative control colonoscopy identified a coil-spring polypoid mass with normal mucosa at the level of anastomosis. There was no sign of ischemia and mucosal fold intussusception was suspected. A reduction with balloon dilatation was performed successfully during colonoscopy. After reduction, the anastomosis was revealed with normal appearance of mucosa and the bowel function was corrected. Biopsies taken of the lead point of the obstructive mass confirmed the presence of intestinal mucosa. Mucosal fold intussusception is a rare cause of postoperative bowel obstruction at the site of anastomosis. In these cases, endoscopic balloon dilatation could be proved safe and efficient, avoiding a potentially unnecessary bowel resection. Key words: Adult intussusception, management
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