Clin Endosc > Volume 55(4); 2022 > Article
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Choi and Moon: A rare case of intussusception in a patient with ulcerative colitis

Quiz

A 49-year-old female patient with ulcerative colitis (UC) who had opted out of treatment of her own accord visited the emergency room because of hematochezia. The day before visiting our hospital, the patient underwent sigmoidoscopy at a local hospital. Sigmoidoscopy revealed mucosal edema, erythema, and exudate in the rectum (Fig. 1A). In addition, abdominopelvic computed tomography (CT) showed a mass like lesion at the hepatic flexure (Fig. 1B). She was transferred to our hospital for further evaluation. Colonoscopy was performed the following day. A large circular mass that entirely blocked the lumen was observed at the hepatic flexure, and we performed a biopsy of the lesion to rule out colon cancer (Fig. 1C). In addition, nodularity, erythema, friable mucosa, and geographical ulcerations were observed, extending from the distal sigmoid colon (20 cm from the anal verge) to the rectum. Pathological findings were unremarkable. On day 3, following hospitalization, follow-up abdominopelvic CT was performed to evaluate the bowel state, and the mass found previously at the hepatic flexure was no longer visible (Fig. 1E).
What is the most likely diagnosis?
 

NOTES

Conflicts of Interest
The authors have no potential conflicts of interest.
Funding
None.
Author Contributions
Conceptualization: HSM; Investigations and visualization: SWC; Writing-review & editing: SWC, HSM.

Fig. 1.
(A) Initial sigmoidoscopy revealed mucosal edema, erythema, and exudates. (B) Initial abdominopelvic computed tomography (CT) scan showed a mass like lesion at the hepatic flexure (arrow). (C, D) Follow-up colonoscopy revealed a mass-like lesion was observed at the hepatic flexure. (E) Follow-up abdominopelvic CT 3 days later showed the absence of a mass-like lesion at the hepatic flexure.
ce-2022-155f1.jpg
Fig. 2.
Histologically, the mass at the hepatic flexure was determined to be acute and chronic inflammation with inflamed granulation tissue (hematoxylin & eosin stain, ×100).
ce-2022-155f2.jpg
Fig. 3.
(A, B) Follow-up colonoscopy 4 months later revealed no lesion at the hepatic flexure and marked improvement of the inflamed mucosal lesions at the rectum.
ce-2022-155f3.jpg

REFERENCES

1. Martínez-Ubieto F, Jiménez-Bernadó T, Bueno-Delgado A, et al. Recurrent intestinal intussusception in an adult due to intestinal pseudopolyps not associated with inflammatory bowel disease: a case report. J Med Case Rep 2015;9:260.
crossref pmid pmc
2. Honjo H, Mike M, Kusanagi H, et al. Adult intussusception: a retrospective review. World J Surg 2015;39:134–138.
crossref pmid pmc pdf
3. Tanabe T, Furukawa S, Masuda T, et al. Asymptomatic colonic intussusception in ulcerative colitis: a case report. J Surg Case Rep 2020;2020:rjaa050.
crossref pmid pmc pdf
4. Marinis A, Yiallourou A, Samanides L, et al. Intussusception of the bowel in adults: a review. World J Gastroenterol 2009;15:407–411.
crossref pmid pmc
5. Kim KH. Intussusception in adults: a retrospective review from a single institution. Open Access Emerg Med 2021;13:233–237.
crossref pmid pmc pdf
6. Yakan S, Caliskan C, Makay O, et al. Intussusception in adults: clinical characteristics, diagnosis and operative strategies. World J Gastroenterol 2009;15:1985–1989.
crossref pmid pmc
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