Year 2023 / Volume 115 / Number 8
Letter
Adult sigmoidorectal intussusception as an unexpected cause of lower gastrointestinal bleeding

464-465

DOI: 10.17235/reed.2022.9333/2022

Jean Félix Piñerúa-Gonsálvez, Carmen del Pozo Calzada, Rosanna del Carmen Zambrano-Infantino,

Abstract
A 95-years-old woman presented with sudden-onset rectal bleeding. All other systems were reviewed and were negative. The patient had a past medical history of Alzheimer disease, congestive heart failure, arterial hypertension and diabetes mellitus type 2. Vital signs were normal. There were neither signs of peritoneal irritation nor intestinal obstruction. On digital rectal examination, a soft mass was palpated about 9 cm from the anal verge. Routine analytical tests were within normal limits. The abdominal CT showed a sigmoidorectal intussusception. It was performed a colonoscopy revealing a segment of sigmoid telescoping into the rectum about 15cm from the anal verge. On this invaginated segment, there was a large sessile polyp, which was biopsied. Rectal bleeding was self-limited without additional measures. The histological examination showed tubular adenoma with high-grade dysplasia. Intussusception in the adult is uncommon, representing less than 5% of all cases of intussusception. Most of the cases are due to malignant lesions, which are pulled forward during peristalsis, leading to invagination. The early diagnosis represents a diagnostic challenge due to the clinical features are nonspecific, including symptoms of intestinal obstruction and rectal bleeding.
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References
1. Mohamed M, Elghawy K, Scholten D, Wilson K, McCann M. Adult sigmoidorectal intussusception related to colonic lipoma: A rare case report with an atypical presentation. Int J Surg Case Rep. 2015;10:134-7.
2. Ford Kt, Lopez S, Synghal G, Fayiga Y, Carter B, Kandel A, et al. Pedunculated sigmoid lipoma causing colo-colonic intussusception. Proc (Bayl Univ Med Cent). 2021;34(3):371-2.
3. Filiberto AC, Loftus TJ, Tan SA, Read TE, Iqbal A. Sigmoido-rectal intussusception. SAGE Open Med Case Rep. 2019;7:2050313X19856242.
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Piñerúa-Gonsálvez J, del Pozo Calzada C, Zambrano-Infantino R. Adult sigmoidorectal intussusception as an unexpected cause of lower gastrointestinal bleeding. 9333/2022


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Publication history

Received: 03/11/2022

Accepted: 09/11/2022

Online First: 22/11/2022

Published: 26/07/2023

Article Online First time: 19 days

Article editing time: 265 days


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