Colocolonic Intussusception of a Giant Pseudopolyp in a Patient With Ulcerative Colitis

Abstract

Adult intussusception in the setting of inflammatory bowel disease (IBD) is a rare phenomenon. Giant pseudopolyps, while generally considered benign, may function as lead points for intussusception. Diagnosis and management of intussusception in the setting of IBD can be fraught with hazards. We report the case of a 27-year-old male, recently diagnosed with ulcerative colitis and giant pseudopolyps, who presented with colocolonic intussusception and obstruction. Diagnosis was confirmed using CT imaging and the patient underwent resection of the colocolonic intussusception without reduction. The following case underscores the challenges in managing adult intussusception in the setting of IBD and allows for a review of the literature to date. Resection of non-reduced intussusception, rather than endoscopic or enema reduction, should continue to be definitive treatment of patients presenting with this unusual problem.

Transient ileocolic intussusception in a dog with histiocytic ulcerative tiflocolitis: a case report

“…However, nothing is described related to the localisation of intussusceptions in dogs with inflammatory bowel disease (Oliveira-Barros et al 2009). In humans with inflammatory bowel disease several localisations have been described, such as ileoileal (Knoweles et al 1989;Lopez-Tomassetti et al 2006), colocolonic (Maldonado et al 2004;Coghlan et al 2010), or ileocolic (Kihiezak and Rosenfeld 1998). It has been described that intussusceptions in Crohn's disease are expected to be found in the ileal and more proximal bowel (Maconi et al 2007), suggesting a possible relationship between localisation of the disease and type of intussusceptions.…”

“…Adult intussusceptions in the setting of inflammatory bowel disease in humans is a rare phenomenon, but some reports are described (Knowles et al 1989;Kihiezak and Rosenfeld 1998;Maldonado et al 2004;Lopez-Tomassetti et al 2006;Maconi et al 2007;Coghlan et al 2010). This condition has been also described in some cases of eosinophilic enteritis, an uncommon condition in humans (Kshirsagar et al 2007;Shin et al 2007).…”

Cecal Intussusception in an Adult with Cronkhite-Canada Syndrome Relieved by Colonoscopy

“…Intussusceptions associated with CCS have been reported as a case report in at least four patients in Japanese language up to 2007 (17)(18)(19) (24,25).…”

Colocolic Intussusception in a Patient with Ulcerative Colitis

“…Other drawbacks include the increased risk of anastomotic complications (the bowel wall may be weakened during manipulation) and the potential for bowel perforation and seeding of microorganisms and tumor cells to the peritoneal cavity. 2,3,7,10 Management of intussusception in patients with inflammatory disease is also controversial. Most authors prefer surgical resection, although there are isolated reports of nonoperative management.…”