P2018 - A Case of Colo-colonic Intussusception Post-Polypectomy

Gurjot Singh, DO¹, Kailtyn M. Egger, DO², Elizabeth Decker, DO^2
1The Warren Alpert Medical School of Brown University, Warwick, RI; ²Kent Hospital, Warwick, RI

Introduction: Intussusception is a condition by which the gastrointestinal tract telescopes the proximal segment of the intestine into the distal portion. This condition is often seen in the pediatric population however, can uncommonly be seen in adults with the primary cause of intussusception secondary to polyps, lipomas, or carcinomas. This rare case follows the course of a patient who developed colo-colonic intussusception post polypectomy.

Case Description/Methods: A 65-year-old female with a past medical history of hypothyroidism and GERD with no prior abdominal surgeries presented to the emergency department with primary complaints of left lower quadrant abdominal pain, flank pain, vomiting, and diarrhea 8 hours after colonoscopy with polypectomy. During the patient's colonoscopy, a 3mm polyp in the descending colon consistent with lymphoid aggregate and 4mm hyperplastic polyp in the sigmoid colon were removed with cold snare. Post-procedurally the patient was unable to tolerate food with 2 episodes of clear emesis and 2 liquid brown bowel movements. Labs on admission were notable for WBC of 14.1 x10^3/mcL, BUN of 23mg/dL, creatinine of 1.05mg/dL, and lactic acid of 1.1mmol/L. Patient underwent computer tomography (CT) of the abdomen pelvis which demonstrated intussusception of the transverse colon without large bowel obstruction or lead point. Surgery team was consulted however, surgical intervention was deferred. Gastrografin enema was not recommended by radiology. Patient underwent colonoscopy which demonstrated an area of congested mucosa at the splenic flexure, hyperemic mucosa with some patchy darkening but no dusky nor ischemic appearance. Patient was kept n.p.o. for 1 day after colonoscopy with clinical improvement and was able to tolerate a diet with resolution of all symptoms.

Discussion: Colo-colonic intussusception is uncommonly seen in adults and even less commonly seen in the absence of a lead point such as a polyp, lipoma, or carcinoma. This case highlights a very rare presentation of colo-colonic intussusception after polypectomy resolving without surgical or endoscopic intervention.


Disclosures:


Gurjot Singh, DO¹, Kailtyn M. Egger, DO², Elizabeth Decker, DO². P2018 - A Case of Colo-colonic Intussusception Post-Polypectomy, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.