VideoGIE
Sigmoid colon cancer with intussusception reduced by colonoscopy
Figure 1. A, Colonoscopy showed sigmoid colon intussusception with segmental mucosa congestion. B, Surgical specimen proved polypoid colon cancer with peripheral congestive mucosa.
Colon intussusception is a rare clinical situation secondary to colon tumor. Colonoscopy, a most useful tool for screening, could be used cautiously to reduce intussusception. A 77-year-old man, who had not experienced systemic disease previously, had noticed intermittent hematochezia for 3 months. An elective colonoscopy without the use of sedation was performed after the bowel was prepared with sodium phosphate. Before colonoscopy, the patient did not experience any discomfort, and the physical examination showed a soft abdomen but no obvious peritoneal irritation. During the colonoscopy, a tumor with intussusception was observed at the rectosigmoid colon (Fig. 1A). The tumor had congestive mucosa, with neither ulceration nor hemorrhage. The intussusception was reduced by colonoscopy with caution
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www.giejournal.org
by gentle air inflation, and the colonoscope was advanced slowly (Video 1, available at www.giejournal.org). During the colonoscopic reduction, the patient did not describe feeling discomfort. A biopsy of the tumor was performed, and examination of the biopsy specimen showed adenocarcinoma grade 2. After staging with computed tomography, an elective laparoscopic anterior resection of the tumor was done. The surgical specimen showed sigmoid colon cancer, T2N0M0, stage I (Fig. 1B), and the patient was discharged after his general condition became stable. DISCLOSURE All authors disclosed no financial relationships relevant to this publication. Wen-Hung Hsu, MD, Chien-Yu Lu, MD, HuangMing Hu, MD, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan http://dx.doi.org/10.1016/j.gie.2015.05.008
Volume 82, No. 4 : 2015 GASTROINTESTINAL ENDOSCOPY 753
Sigmoid colon cancer with intussusception reduced by colonoscopy
Figure 1. A, Colonoscopy showed sigmoid colon intussusception with segmental mucosa congestion. B, Surgical specimen proved polypoid colon cancer with peripheral congestive mucosa.
Colon intussusception is a rare clinical situation secondary to colon tumor. Colonoscopy, a most useful tool for screening, could be used cautiously to reduce intussusception. A 77-year-old man, who had not experienced systemic disease previously, had noticed intermittent hematochezia for 3 months. An elective colonoscopy without the use of sedation was performed after the bowel was prepared with sodium phosphate. Before colonoscopy, the patient did not experience any discomfort, and the physical examination showed a soft abdomen but no obvious peritoneal irritation. During the colonoscopy, a tumor with intussusception was observed at the rectosigmoid colon (Fig. 1A). The tumor had congestive mucosa, with neither ulceration nor hemorrhage. The intussusception was reduced by colonoscopy with caution
This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store.
www.giejournal.org
by gentle air inflation, and the colonoscope was advanced slowly (Video 1, available at www.giejournal.org). During the colonoscopic reduction, the patient did not describe feeling discomfort. A biopsy of the tumor was performed, and examination of the biopsy specimen showed adenocarcinoma grade 2. After staging with computed tomography, an elective laparoscopic anterior resection of the tumor was done. The surgical specimen showed sigmoid colon cancer, T2N0M0, stage I (Fig. 1B), and the patient was discharged after his general condition became stable. DISCLOSURE All authors disclosed no financial relationships relevant to this publication. Wen-Hung Hsu, MD, Chien-Yu Lu, MD, HuangMing Hu, MD, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan http://dx.doi.org/10.1016/j.gie.2015.05.008
Volume 82, No. 4 : 2015 GASTROINTESTINAL ENDOSCOPY 753
