Colo-colonic intussusception as a rare complication of colonoscopy with polypectomy: Two case reports

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.

Keywords: Intussusception; Colonoscopy; Polypectomy; Complication; Case report

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.