ADULT ILEOCOLIC INTUSSUSCEPTION IN CAECAL ADENOCARCINOMA – AN INFREQUENT PHENOMENON

Abstract

Intussusception is a common condition which radiologists come across on a day-to-day basis. However, this entity is uncommonly encountered in the adult population, causes of which most often attributed to a lead point. The growing use of CT has enabled radiologists to make timely diagnosis in order to prevent complications of acute abdomen. The author reports a case of a 56-year-old lady who had a previous history of blood transfusion for anemia, presented with chronic right sided and epigastric pain. These are associated with constipation, diarrhoea, tenesmus and constitutional symptoms. Clinical examination revealed mild pallor, palpable epigastric mass. CT showed a large sausage-shaped mass with features suggestive of intussusception of the caecum and terminal ileum into the ascending colon along with small bowel faeces sign. A focal enhancing mass simulating segmental bowel thickening is seen as a lead point. Open right hemicolectomy and ileocolic anastomosis were undertaken with the histopathological examination yielding a poorly differentiated caecal adenocarcinoma. Review of the radiopathological correlation of this entity is also outlined.

Acknowledgement: Radiology Department, Sultan Ahmad Shah Medical Centre (SASMEC)