Sigmoido-rectal intussusception.
Amanda C FilibertoTyler J LoftusSanda A TanThomas E ReadAtif IqbalPublished in: SAGE open medical case reports (2019)
Rectal prolapse is usually of benign etiology. Rarely, sigmoido-rectal intussusception results from a malignant lead-point. We report the case of a patient with a partially obstructing sigmoid cancer causing a full thickness rectal prolapse requiring surgical intervention. An 82-year-old woman presented with 1 week of rectal bleeding, fecal incontinence, and weight loss. Computed tomography identified sigmoido-rectal intussusception. Colonoscopic biopsy revealed high-grade dysplasia. Magnetic resonance imaging demonstrated a 6-cm mass forming the lead point of the intussusceptum with epiploic appendages seen within the rectal lumen. She underwent laparoscopic low anterior resection with final pathology consistent with T2N0 adenocarcinoma, and recovered well. Among adult patients with rectal prolapse, suspicion for underlying malignancy should prompt a thorough investigation to inform the decision for resection, which may be safely performed by minimally invasive techniques.
Keyphrases
- rectal cancer
- computed tomography
- magnetic resonance imaging
- high grade
- minimally invasive
- weight loss
- squamous cell carcinoma
- locally advanced
- bariatric surgery
- type diabetes
- case report
- robot assisted
- positron emission tomography
- magnetic resonance
- contrast enhanced
- decision making
- weight gain
- image quality
- placebo controlled
- squamous cell