Discussion:
Intussusception is defined as the telescoping of the proximal loop of the intestine into the distal loop resulting in obliteration of the lumen. Intussusception in the small bowel seems to be most common than intussusception in the large bowel. Whereas intussusception is relatively common in children, it is clinically rare in adults [2]. Approximately 50% of the colonic intussusception in adults are due to malignant tumours [3,4,5]. Apart from malignant etiologies, there are other causes of colonic intussusception, such as submucosal lipomas, adenomatous polyps and leiomyomas. The clinical signs are polymorphic and often misleading, such as an acute intestinal obstruction, a sub-occlusive syndrome or sometimes a nonspecific abdominal syndrome [6]. Because of these nonspecific symptoms, intussusception can be misdiagnosed. Increased computed tomography scan to evaluate patients with abdominal pain can contribute to a reliable preoperative diagnosis. The abdominal ultrasound associated with colour Doppler is a rapid examination that can reveal the invagination coil [1], but it is not useful in diagnosing adult intussusceptions. The CT scanner has proved to be more accurate, with an accuracy of almost 100%, by showing two typical images: a ”sandwich” image in longitudinal section showing the head of the acute intestinal invagination and a ”cockade” image in cross-section showing the coil of the acute intestinal invagination [7]. The surgical approach is influenced by the prevalence of associated malignancy, the anatomic site, and various local factors such as the degree of associated ischemia of the involved bowel [2]. Primary surgical resection without prior reduction is the treatment of choice in colocolic adult intussusception [8,9,10].