A Case of Idiopathic Rectosigmoid Intussusception in Adult

Masahiro Sakaguchi, Katsuyoshi Tabuse, Seiki Yamamoto, Sumikazu Oka, Nakahiro Shimotsuma, Tetsuya Horiuchi, Koji Minami, Mikihiro Uenishi

Department of Surgery, Osaka-Minami National Hospital

Our experience with idiopathic intussusception (rectosigmoid intussusception) in a 90-year-old women is reported. The patient presented with the chief complaint of blood-stained mucous stools. On rectal examination through the anal canal, a reddish brown mass was found in the rectum with blood-stained mucous feces being evacuated from the center of the mass. A diagnosis of rectosigmoid intussusception was therefore made. Radiography, ultrasonography and computed tomographic scanning consistently revealed a concentric mass within the pelvic cavity, which was quite helpful in establishing the above diagnosis. At surgery, the sigmoid colon, together with the sigmoid mesocolon, was found to invaginate into the rectal lumen at 5 cm from the peritoneal reflection, and this confirming the diagnosis of rectosigmoid intussusception. The tip of the intussusceptum was swollen and edematous with partial necrosis but without any organic change such as tumor formation. In general, the majority of large bowel intussusceptions in adult occur as a result of organic diseases. The idiopathic rectosigmoid intussuception seen in our case is therefore an extremely rare example.

Key words
intussusception in adult, idiopathic intussusception

Reprint requests
Masahiro Sakaguchi Department of Surgery, Osaka-Minami National Hospital
677-2 Kido-cho Kawachinagano, 586 JAPAN

Accepted
February 13, 1991

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