Intraoperative colonoscopy and surgical treatment in patients with ILE-colic intussuspection secondary to polyp

Abstract text (incl. references and figure legends)

A 66-year-old woman, with a history of hypertension, Forrest III prepyloric ulcer, not previous abdominal surgeries, was admitted to the emergency department wit abdominal pain and diarrhea with blood remains, associating loss of 3 kg. In the analysis, mild anemia, slight leukocytosis and elevation of acute phase reactants stand out. Five days earlier she went to another center for abdominal pain and diarrhea, being diagnosed with enterocolitis and discharged.CT body was performed with findings "compatible with ileocolic intussusception with head of intusspection in the transverse colon, with distension probably of the cecum but without dilation of loops of small intestine and with a small amount of intraperitoneal free fluid, not being able to rule out, given the findings, underlying lesion in the head of intussusception.Given these findings, preparation for urgent colonoscopy and surgery begins. In the operating room, colonoscopy is performed with a finding of "suspected transverse colon neoplasia", so a laparotomy, enlarged right hemicolectomy and reconstruction with manual ileo-colic anastomosis are carried out.After the intervention, the patient is discharged after 6 days of admission, with tolerance to oral diet and transit for gas and feces, without complications. The anatomical-pathological diagnosis was a "tubulovillous adenoma with high-grade dysplasia, 18 lymph nodes with no evidence of malignancy.Discussion: Intestinal intussuspection is a rare cause of intestinal obstruction in adults. Unlike the child, most cases in adults are secondary (mainly, benign and malignant tumors). Abdominal CT is the diagnostic test to confirm;The management in general is surgical: a resection will be carried out without reduction of intussuspection(suspicion of malignant;no viability of the intestine,while in the rest of cases a manual reduction prior to resection. Hong KD, Kim J, Ji W, WSD.Adult intussusception:asystematicreviewandmetaanalysisTech Coloproctol.2019;23(4).

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