Colonic intussusception masquerading as diverticulitis: a case report of a 31 year old diagnosed with colorectal carcinoma after multiple presentations to the ED for episodes of acute diverticulitis

Abstract

Colonic intussusception is a rare occurrence in adults, with few reported cases in the literature. Patients often present with nonspecific and vague symptoms leading to diagnostic challenges and delayed treatment. Given the high incidence of underlying malignancy associated with cases of adult intussusception, it is important for clinicians to be able to recognize and coordinate appropriate follow-up. A 31-year-old female presented to the emergency department four times over a month with left lower quadrant abdominal pain. Multiple computed tomography scans showed inflammation and diverticulitis of the mid-descending colon along with a short segment of colonic intussusception. A colonoscopy was performed due to concern for malignancy. A partially obstructing mass was found in the descending colon that could not be traversed. Biopsies revealed necrosis and no evidence of malignancy. However, given high suspicion for malignancy, the patient underwent a laparoscopic left colectomy, which revealed a pT3N1b colon adenocarcinoma.