Adult colorectal intussusception

Abstract

A 30-year-old woman presented with severe lower, colicky abdominal pain and difficulty in passing flatus. Clinical examination revealed suprapubic tenderness. An abdominal CT was performed which revealed a soft-tissue mass in the pelvis demonstrating ‘a target sign’ appearance confirming the diagnosis of intussusception. The effect of the intussusceptum within the intussuscipiens creates a layered appearance. There is loss of gas within the rectum, instead, this is replaced by a soft-tissue mass of fat density (Hounsfield units −10). A diagnosis of rectosigmoid intussusception was carried out based on the CT findings with a presumptive diagnosis of an intramural lipoma as the primary lead point. Surgical reduction was performed with resection of the distal sigmoid colon. Histology confirmed an intramural lipoma of the sigmoid colon.