Limits...
Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature.

Reiser-Erkan C, Erkan M, Ulbrich E, Nährig J, Kleeff J - BMC Surg (2010)

Bottom Line: A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain.The clinical picture mimicked acute appendicitis.Intraoperatively, no full thickness invagination was detected.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.

ABSTRACT

Background: Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass.

Case presentation: A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain. The clinical picture mimicked acute appendicitis. Transabdominal ultrasound examination revealed a 5 cm circular mass in the right upper abdomen. The ensuing computed tomography suggested an intussusception in the ascending colon. Intraoperatively, no full thickness invagination was detected. Due to a hard, intraluminal tumor a standard right hemicolectomy with ileotransversostomy was performed. The histopathological analysis revealed a cystic colon duplication leading to mucosal invagination and obstruction.

Conclusions: In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions. Unlike its preferentially nonsurgical management in children, a bowel intussusception in adults should be operated because an organic, often malignant lesion is present in most cases.

Show MeSH

Related in: MedlinePlus

Macroscopical and histopathological findings of the specimen. A) The right hemicolon opened with the cystic duplication. B) The stool-filled cystic lesion is cut open. Notice the mucosal ulcerations (closed arrows). The open arrow depicts the ileo-ceacal area. C) Histopathological demonstration of the duplication cyst.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2909170&req=5

Figure 2: Macroscopical and histopathological findings of the specimen. A) The right hemicolon opened with the cystic duplication. B) The stool-filled cystic lesion is cut open. Notice the mucosal ulcerations (closed arrows). The open arrow depicts the ileo-ceacal area. C) Histopathological demonstration of the duplication cyst.

Mentions: Intraoperatively, there was a firm intraluminal mass palpable in the ascending colon. A standard non-oncological right-hemicolectomy was performed. Intraoperative opening of the specimen revealed a circular, mucosa covered intraluminal mass acting as the leading point that caused partial mucosal invagination and obstruction. The stool filled saccular lesion had ulcerous areas visible on the mucosal surface (Figure 2A, B). Since there was no macroscopic evidence of malignancy, no further radical lymph-node dissection was made and the bowel continuity was re-established by an ileotransversostomy. The postoperative course was uneventful. Histopathological examination revealed a cystic colonic duplication (Figure 2C).


Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature.

Reiser-Erkan C, Erkan M, Ulbrich E, Nährig J, Kleeff J - BMC Surg (2010)

Macroscopical and histopathological findings of the specimen. A) The right hemicolon opened with the cystic duplication. B) The stool-filled cystic lesion is cut open. Notice the mucosal ulcerations (closed arrows). The open arrow depicts the ileo-ceacal area. C) Histopathological demonstration of the duplication cyst.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2909170&req=5

Figure 2: Macroscopical and histopathological findings of the specimen. A) The right hemicolon opened with the cystic duplication. B) The stool-filled cystic lesion is cut open. Notice the mucosal ulcerations (closed arrows). The open arrow depicts the ileo-ceacal area. C) Histopathological demonstration of the duplication cyst.
Mentions: Intraoperatively, there was a firm intraluminal mass palpable in the ascending colon. A standard non-oncological right-hemicolectomy was performed. Intraoperative opening of the specimen revealed a circular, mucosa covered intraluminal mass acting as the leading point that caused partial mucosal invagination and obstruction. The stool filled saccular lesion had ulcerous areas visible on the mucosal surface (Figure 2A, B). Since there was no macroscopic evidence of malignancy, no further radical lymph-node dissection was made and the bowel continuity was re-established by an ileotransversostomy. The postoperative course was uneventful. Histopathological examination revealed a cystic colonic duplication (Figure 2C).

Bottom Line: A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain.The clinical picture mimicked acute appendicitis.Intraoperatively, no full thickness invagination was detected.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.

ABSTRACT

Background: Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass.

Case presentation: A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain. The clinical picture mimicked acute appendicitis. Transabdominal ultrasound examination revealed a 5 cm circular mass in the right upper abdomen. The ensuing computed tomography suggested an intussusception in the ascending colon. Intraoperatively, no full thickness invagination was detected. Due to a hard, intraluminal tumor a standard right hemicolectomy with ileotransversostomy was performed. The histopathological analysis revealed a cystic colon duplication leading to mucosal invagination and obstruction.

Conclusions: In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions. Unlike its preferentially nonsurgical management in children, a bowel intussusception in adults should be operated because an organic, often malignant lesion is present in most cases.

Show MeSH
Related in: MedlinePlus