A Case of Intussusception due to Carcinoma of the Sigmoid Colon in Association with Water-electrolyte Imbalance and Severe Hypoproteinemia

Hiroki Akamatsu, Masaki Kamegashira, Muneyuki Fujita, Atsushi Okawa, Motoo Yoshitatsu

Department of Surgery, Ashiya City Hospital

Intussusception in adults is rare, accounting for about 5% of all intussusceptions. Its most common clinical symptoms are abdominal pain, abdominal distension and hematochezia according to the literature. An adult case of intussusception due to sigmoid colon carcinoma, which caused water-electrolyte imbalance and severe hypopro-teinemia, is reported. The patient was a 64-year-old man, who was admitted suffering from massive mucus diarrhea. His general condition was poor owing to dehydration, at the time of admission. Sigmoidoscopy was performed after the diarrhea stopped but revealed no apparent lesion. The patient was then discharged and followed up on an outpatient basis. Three months later he was readmitted because of recurrence of diarrhea. Intussusception due to sigmoid colon carcinoma was diagnosed by fiberoptic colonoscopy and a sigmoidectomy was performed. This patient developed clinical symptoms like so-called depletion syndrome associated with a villous tumor of the colon and the rectum since a large amount of mucoid material excreted secondary to intussusception was lost without reabsorption by the colon because of the closeness of the intussusception to the anus. The diagnosis of intussusception is relatively easy by endoscopy, but care must be taken when an intussusception is spontaneously reduced.

Key words
intussusception, carcinoma of colon, depletion syndrome

Reprint requests
Hiroki Akamatsu Department of Surgery, Ashiya City Hospital
39-1 Asahigaoka-cho, Ashiya, 659 JAPAN

Accepted
March 13, 1991

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