Intussusception. An Emergency case of large bowel obstruction

Abstract text (incl. references and figure legends)

A 66-year-old woman with a medical history of HTA, DM and surgical cholecystectomy and hysterectomy.He goes to the emergency room for rectorrhagia, abdominal pain and obstructive clinic. On physical examination, abdominal distension is observed and on rectal examination an indurated and ulcerated mass about 5-6 cm from the external anal margin. As complementary tests, blood test is performed where anemia is observed without further alterations and a CT scan with contrast where a colorectal intussusception secondary to neoplasia probably in recto-sigma is objective. Supportive treatment is initiated, SNG is placed and NPT is requested and it is decided to complete the study by performing a Ct body and a colonosopia CT. In both, persistence ofintussusception of the sigma in the rectum secondary to a sigmoid mamelonate lesion without distant involvement was observed. It is decided before the intervention findings performing open sigmoidectomy (it is tried to perform by laparoscopy without success due to the distension of the loops). A laparotomy is performed, with a sigma-dependent tumor, with intussusception of the left colon and upper rectum, and monthly retractionwithout associated peritoneal carcinomatosis.Discussión:Bowel obstruction occurs when the normal flow of intraluminal contents is blocked. Large bowel obstruction constitutes approximately 25 percent of all intestinal obstructions. The obstruction is the initial presenting symptom of up to 30 percent of colon cancers. The most common location of obstructing colorectal cancer is at the sigmoid colon.Large bowel intussusception is a rare condition associated with clinical obstrucción y high mortality if left untreated. Surgery of intussuspecition is made with laparosocopic or open approach We report a patient who underwent open approach with a good postoperative course.Buechter KJ, Boustany C, Caillouette R. Surgical management of the acutely obstructed colon. A review of 127 cases. Am J Surg 1988.

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