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Endoscopy 2022; 54(12): E737-E738
DOI: 10.1055/a-1773-0602
E-Videos

Colocolonic intussusception identified during endoscopy: an incidental diagnosis

Steve Hu
1   Department of Medicine, Division of Gastroenterology and Hepatology, Harbor-UCLA Medical Center, Torrance, California USA
,
William K. Carson
2   California Medical Imaging Radiology Group, Fresno, California, USA
,
Jaya Krishna Chintanaboina
3   Department of Gastroenterology and Hepatology, UCSF Fresno, Fresno, California, USA
,
Devang N. Prajapati
3   Department of Gastroenterology and Hepatology, UCSF Fresno, Fresno, California, USA
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A 42-year-old man with no prior medical history presented with perianal pain and pustular drainage over the course of 1 week. On physical examination, he had a perianal abscess with a draining sinus tract, but no abdominal tenderness to palpation. Laboratory tests showed severe iron deficiency anemia. As part of a workup for this, an upper gastrointestinal endoscopy was performed, which was unremarkable. Subsequently, a colonoscopy was performed, which revealed no mucosal inflammation but did show a large focal region of the mid-transverse colon, which spontaneously protruded and retracted ([Video 1]). To evaluate this further, a computed tomography (CT) scan was performed, which revealed a colocolonic intussusception of the transverse colon, without any focal neoplasm ([Fig. 1]). The patient’s perianal abscess improved on antibiotics without the development of any further symptoms and he was discharged home.

Video 1 Endoscopy showing a colocolonic intussusception of a focal region of the mid-transverse colon.


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Fig. 1 Coronal oral and intravenous contrast-enhanced computed tomography (CT) image displaying a colocolonic intussusception (arrow).

Colocolonic intussusception is a rare finding and is usually associated with malignancy in adults, but can also occur spontaneously [1]. About 20 % of such cases are transient or asymptomatic in adults and may not necessitate surgical intervention [2]. Abdominal CT can accurately diagnose intussusception in approximately 78 % of patients; findings typically include a target-like or sausage-shaped mass with a layering effect [3] [4]. Endoscopy provides invaluable information through direct visualization in order to precisely determine the lead point, as demonstrated by this case.

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Publication History

Article published online:
10 March 2022

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