1. IDIOPATHIC ADULT COLO-COLONIC INTUSSUSCEPTION
DR:SHAHID YAKOOB , FIRST YEAR MDRD STUDENT , VINAYAKA MISSIONS KIRUPANANDA VARIYAR MEDICAL COLLEGE, SALEM.
Aims and Objectives:
To give an overview of idiopathic colo-colonic intussusception in adult.
Materials and methods:
I present a 75 year old women who was referred to our radiology department with recurrent abdominal pain for past 3 months and mobile mass palpabe in right hypogastric region.
Results:
Intussusception remains a rare condition in adults, representing 1–5% of bowel obstruction and accounting for 0.003–0.02% of all hospital admissions. Intussusception occurs more frequently in the small (50–80%) than in the large bowel (12–50%). It is estimated that approximately 90% of intussusceptions in adults are secondary to an anatomical or pathological condition, of which more than half are malignant. Idiopathic cases are the exception in adults. The clinical presentation of adult intussusception differs considerably from the classic pediatric presentation of abdominal pain, palpable mass, and blood per rectum, which is rarely seen in adults. USG abdomen showed hypoechoic ring surrounding echogenic centre giving rise to “target / doughnut sign” in transverse sections , bowel within bowel giving rise to “sandwich / pseudokidney sign” in longitudinal sections, mucosa of intussusceptum giving rise to echogenic centre and outer hypoechoic rim due to edematous wall of intussuscipiens suggestive of idiopathic colo-colonic intussusception with oedematous proximal colon.
CONCLUSION:
There are few reports in the medical literature of colo-colonic intussusception occurring in adults without any pathological cause.
Clinical relevance / take home message:
A more careful approach is needed to rule out idiopathic adult intussusception without classic presentations.