Colonic intussusception after endoscopic mucosal resection successfully managed by endoscopic procedure

Keiichi Hashiguchi; Shoichiro Mine; Junya Shiota; Taro Akashi; Maiko Tabuchi; Moto Kitayama; Kayoko Matsushima; Yuko Akazawa; Naoyuki Yamaguchi; Kazuhiko Nakao

doi:10.1007/s12328-024-01953-8

Colonic intussusception after endoscopic mucosal resection successfully managed by endoscopic procedure

Clin J Gastroenterol. 2024 Mar 20. doi: 10.1007/s12328-024-01953-8. Online ahead of print.

Authors

Keiichi Hashiguchi^{1

2}, Shoichiro Mine³, Junya Shiota⁴, Taro Akashi⁴, Maiko Tabuchi⁵, Moto Kitayama⁴, Kayoko Matsushima⁶, Yuko Akazawa⁵, Naoyuki Yamaguchi⁷, Kazuhiko Nakao⁴

Affiliations

¹ Department of Endoscopy, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan. khashiguchi@nagasaki-u.ac.jp.
² Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. khashiguchi@nagasaki-u.ac.jp.
³ Department of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
⁴ Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
⁵ Department of Histology and Biomedical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
⁶ Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan.
⁷ Department of Endoscopy, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan.

PMID: 38504057
DOI: 10.1007/s12328-024-01953-8

Abstract

Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.

Keywords: Adult; Colon; Endoscopic mucosal resection; Endoscopy; Intussusception.