Descending Colon Cancer Associated with Intussusception -Report of a Case-

Hiroyuki Karimata, Yoshito Ikematsu, Kenji Fujitani, Takamitsu Inokuma, Kei Matsuo, Hiroaki Kuroda, Takao Yamamoto, Yoshiro Nishiwaki, Hideo Kida and Shinji Waki

Department of Surgery, Hamamatsu Medical Center

Intussusception in adults is extremely rare, and usually involves an underlining disorder such as colon cancer. We report a rare case of descending colon cancer associated with intussusception. A 54-year-old man suddenly developed abdominal pain and diarrhea followed by vomiting. Palpation of a painful mass in the lower left quadrant and imaging of air-fluid at left colon in plain abdominal radiography led to a diagnosis of colonic ileus, necessitating emergency surgery under a tentative diagnosis of intussusception made based on the specific multiplex layer configuration in CT. At laparotomy, intussusception was confirmed at the middle of the descending colon, necessitating left colectomy with D2 lymphadenectomy without relief of intussusception because of the possibility of underlying malignant disease. A flat elevated lesion 3 cm in diameter was found at the tip of the invaginated intestine in the cut surface of the removed specimen, which was found histologically to be well-differentiated adenocarcinoma with invasion to the proper muscle. Congenital absence of both the splenocolic ligament and fixation between retroperitoneum and descending mesocolon were thought to be responsible in this case.

Key words
descending colon cancer, intussusception

Reprint requests
Yoshito Ikematsu Department of Surgery, Hamamatsu Medical Center
328 Tomitsuka, Hamamatsu, 432-8580 JAPAN

Accepted
April 28, 2004

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