A Case of Retrograde Intussusception due to Semipedunculated Polypiform Adenocarcinoma in Tubular Adenoma of the Sigmoid Colon in an Adult

Masashi Baba, Naozumi Higaki, Masatoshi Ishida and Hiroyasu Kawasaki

Department of Surgery, Kashiwara Municipal Hospital

We report a case of retrograde intussusception due to semipedunculated polypiform adenocarcinoma in a tubular sigmoid colon adenoma in an adult. A 75-year-old woman admitted to our hospital with lower abdominal pain was found in physical examination to have a palpable right-abdomen mass associated with tenderness and Blumberg's sign. Ultrasonography and computed tomography revealed a mass with multiple concentric rings. Abdominal x-ray showed a dilated transverse colon shadow and a crescent of gas outlining a tumor-like mass on the distal side of the colon. We diagnosed retrograde intussusception of the colon and mechanical ileus. Laparotomy showed the sigmoid colon had invaginated retrogradedly into the descending and transverse colon. We conducted left hemicolectomy. The resected specimen was a semipedunculated 6×3×2cm polyp extending from the top of the intussusceptum. Histological examination revealed the polyp to be a well-differentiated adenocarcinoma in the tubular adenoma, with negative lymph node metastasis. This retrograde colonic intussusception in an adult is joining only 24 reported previously in the literature.

Key words
retrograde intussusception, adenocarcinoma in tubular sigmoid colon adenoma, adult intussusception

Reprint requests
Masashi Baba Department of Surgery, Kashiwara Municipal Hospital 1-7-9 Houzenji, Kashiwara, 582-0005 JAPAN

Accepted
November 29, 2000

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