Case presentation:
A 49-year-old male with no past medical history, never operated on the abdomen, presented to the Emergency Department with 3-day history of the obstructive syndrome. Physical exam showed a distended, tympanic abdomen. Digital rectal examination did not find palpable mass. A CT scan showed a left colo-colic intussusception with a dilated proximal colon (Fig 1.a) . Axial abdominal CT scan view showed a typical target sign of intussuscepted bowel (Fig 1.b) . The patient was admitted and underwent emergency laparotomy after a short time of resuscitation. Intraoperatively finding confirmed imagery data. There was an obstruction with distension of the small bowel, caecum, transverse colon ahead of colo-colic intussusception. A hard mass was palped within the intussuscepted bowel. There were neither hepatic metastases nor peritoneal nodes. The manual reduction was not attempted, and we performed a left oncological colectomy (Fig 2) with a double-barrel colostomy. The postoperative course was uneventful, and the patient was discharged after six days. Histopathological examination revealed a well-differentiated adenocarcinoma with mucinous component 20%; there were free surgical margins. Fifteen lymph nodes were found. The final pathology staging was T3N0M0. Immunohistochemically staining showed a stable microsatellite profile. Then the patient was referred to the oncology department for six cycles of FOLFOX spread over six months. Ten months after surgery, he had a negative colonoscopy and repeated abdominal CT scan without local recurrence of metastases. So Restoration of Bowel Continuity was performed.