Xiang SH, Xu GQ. Colo-colonic intussusception as a rare complication of colonoscopy with polypectomy: Two case reports. World J Gastrointest Surg 2024; 16(6): 1939-1947 [DOI: 10.4240/wjgs.v16.i6.1939]
Corresponding Author of This Article
Guo-Qiang Xu, MD, Chief Doctor, Professor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. 1193065@zju.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1939-1947 Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1939
Colo-colonic intussusception as a rare complication of colonoscopy with polypectomy: Two case reports
Sai-Heng Xiang, Guo-Qiang Xu
Sai-Heng Xiang, Guo-Qiang Xu, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Xiang SH contributed to manuscript writing and editing, data collection, and data analysis; Xu GQ guided the treatment and contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Qiang Xu, MD, Chief Doctor, Professor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. 1193065@zju.edu.cn
Received: February 21, 2024 Revised: April 28, 2024 Accepted: May 23, 2024 Published online: June 27, 2024 Processing time: 129 Days and 22.9 Hours
Abstract
BACKGROUND
Colonoscopy is the most frequently used diagnostic and therapeutic tool for the treatment of colorectal diseases. Although the complication rate is low, it can be potentially serious. Intussusception is a rare and severe complication often associated with polypectomy. Only a handful of post-colonoscopy intussusception cases have been reported, making this study a valuable addition to the medical literature.
CASE SUMMARY
Case 1: A 61-year-old man underwent colonoscopy with polypectomy for chronic abdominal pain. The patient experienced abdominal pain 11 hours later but was still discharged after pain management. He was readmitted due to recurring pain. Computed tomography (CT) showed colo-colonic intussusception. Initial conservative management and attempts at endoscopic reduction failed; therefore, laparoscopic right hemicolectomy was performed. Histopathological examination revealed tubular adenomas in the polyps and inflammation in the resected specimens. Case 2: A 59-year-old woman underwent colonoscopy with polypectomy for a polyp in the transverse colon. She experienced upper abdominal pain, fever, nausea, and vomiting 9 hours after the procedure. Emergency CT and blood tests revealed a colo-colonic intussusception near the hepatic flexure and an elevated white blood cell count. Initial attempts at endoscopic reduction failed and conservative treatment showed no improvement. She underwent successful laparoscopic reduction and recovered uneventfully. Histopathological examination of the resected polyp revealed hyperplasia.
CONCLUSION
Post-colonoscopy intussusception in adults is rare, and polypectomy may contribute to its occurrence. Early diagnosis is crucial, with prompt CT examination serving as key. After excluding malignancies, conservative management and reduction of intussusception should be considered before surgical bowel resection.
Core Tip: This study discusses two rare cases of colo-colonic intussusception as a complication of colonoscopy with polypectomy in adults. A 61-year-old man and 59-year-old woman developed intussusception after polyp removal during colonoscopy. Both patients underwent unsuccessful conservative and endoscopic reduction interventions, leading to surgical procedures. These findings highlight the importance of early detection using computed tomography and suggest that polypectomy may increase the risk of intussusception. Conservative management should be attempted before surgical resection, assuming that malignancy has been ruled out. This study highlights the importance of awareness and prompt management of this rare complication.
