Two Cases of Sigmoid Colon Cancer with Intussusception Prolapsing through the Anus

Naruyuki Kobayashi, Ichio Suzuka, Ryuichiro Ohashi, Sadanobu Izumi, Yuji Onoda and Kunihiko Shiota

Department of Surgery, Kagawa Prefectural Central Hospital

Adult intussusception in the large intestine is often headed by a malignant lesion, but the intussusception prolapsing through the anus with sigmoid cancer is rare, only 27 cases have been reported in Japan. In this paper, we present 2 cases of this desease. Case 1 was a 90-year-old woman with dyschezia and lower abdominal pain. The prolapsed colon with a tumor located at the apex through the anus was seen during defecation. Pre-operative examinations including colonoscopy and a gastrografin enema study were done. Case 2 was an 84-year-old woman with lower abdominal pain and a prolapsed colon through the anus. Pre-operative examinations including pelvic computed tomography (CT) were done. In both cases, sigmoidectomy with lymph node dissection (D2) was performed after manual reduction of the intussusception. It is controvertial wheather pre-operative manual reduction of the intussusception should be performed or not. But in our cases, preoperative manual reduction of the intussusception seemed to be plactical. On the other hand, it should be considered to select less invasive transanal colorectomy for an old person with some complication.

Key words
adult intussusception, sigmoid colon cancer, prolapse through the anus

Reprint requests
Naruyuki Kobayashi Department of Surgery, Dohi Hospital
1-14-14, Shiro-machi, Mihara city, 723-0014 JAPAN

Accepted
October 29, 2003

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