M Gesslein1, T Koscheck, B Kusch. 1. Chirurgische Klinik Waldkrankenhaus St. Marien, Erlangen. mgesslein@aol.com
Abstract
HISTORY AND ADMISSION FINDINGS: A 39-year-old patient presented with a history of constipation, abdominal pain and nausea. Magnetic resonance imaging showed a colonic tumour. Biopsy of the tumour did not reveal the diagnosis. INVESTIGATION: The abdomen was tense on palpation and inflammation parameters were elevated. On abdominal x-ray signs of obstructive colonic ileus could be seen. Endoscopic investigation revealed a tumorous stricture of the transverse colon presenting as intussusception with cockade phenomenon during sonography. TREATMENT AND CLINICAL COURSE: Because of obstructive ileus laparotomy was performed with extended right hemicolectomy and end-to-end ileotransversostomy. Histology showed the rare finding of colonic intussusception due to a capillary hemangioma. Post-operative clinical course was normal without any further signs or symptoms of systemic disease. CONCLUSION: Intussusception in adult patients can be a rare complication due to gastrointestinal hemangioma. Endoscopy and radiologic imaging may help to establish diagnosis. Surgical resection of the involved bowel segment seems to be a safe and effective treatment. Nevertheless congenital disease must be excluded to prevent further complications.
HISTORY AND ADMISSION FINDINGS: A 39-year-old patient presented with a history of constipation, abdominal pain and nausea. Magnetic resonance imaging showed a colonic tumour. Biopsy of the tumour did not reveal the diagnosis. INVESTIGATION: The abdomen was tense on palpation and inflammation parameters were elevated. On abdominal x-ray signs of obstructive colonic ileus could be seen. Endoscopic investigation revealed a tumorous stricture of the transverse colon presenting as intussusception with cockade phenomenon during sonography. TREATMENT AND CLINICAL COURSE: Because of obstructive ileus laparotomy was performed with extended right hemicolectomy and end-to-end ileotransversostomy. Histology showed the rare finding of colonic intussusception due to a capillary hemangioma. Post-operative clinical course was normal without any further signs or symptoms of systemic disease. CONCLUSION: Intussusception in adult patients can be a rare complication due to gastrointestinal hemangioma. Endoscopy and radiologic imaging may help to establish diagnosis. Surgical resection of the involved bowel segment seems to be a safe and effective treatment. Nevertheless congenital disease must be excluded to prevent further complications.