Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2019; 7(17): 2536-2541
Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2536
Adult intussusception caused by colonic anisakis: A case report
Youn I Choi, Dong Kyun Park, Hyun Yee Cho, Seung Joon Choi, Jun-Won Chung, Kyung Oh Kim, Kwang An Kwon, Yoon Jae Kim
Youn I Choi, Dong Kyun Park, Hyun Yee Cho, Jun-Won Chung, Kyung Oh Kim, Kwang An Kwon, Yoon Jae Kim, Department of Gastroenterology, Gachon University, Gil Medical Center, Incheon 21565, South Korea
Seung Joon Choi, Department of Pathology, Gachon University Gil Medical Center, Incheon 21565, South Korea
Author contributions: Choi YI, and Park DK contributed to the study concept and design; Choi YI, Cho HY, and Choi SJ analyzed and interpreted the data; Choi YI and Park DK drafed the manuscript; Park DK, Kim KO, Kwon KA, Chung JW and Kim YJ critically revised the manuscript for important intellectual content; all authors approved the final version of the manuscript submitted. All the authors do not declare any conflict of interest.
Informed consent statement: Informed written consent was obtained from the patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: 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/
Corresponding author: Dong Kyun Park, MD, PhD, Doctor, Professor, Department of Gastroenterology, Gachon University, Gil Medical Center, 21 Namdong-daero 774 beon-gil, Incheon 21565, South Korea. pdk66@gilhospital.com
Telephone: +82-32-4603778Fax: +82-32-4603408
Received: May 9, 2019
Peer-review started: May 10, 2019
First decision: June 21, 2019
Revised: June 22, 2019
Accepted: July 20, 2019
Article in press: July 20, 2019
Published online: September 6, 2019
Processing time: 120 Days and 19.1 Hours
Abstract
BACKGROUND

Colo-colonic intussusception is an uncommon phenomenon in an adult. Adult intussusception accounts for < 5% of total cases, and the colo-colonic type is < 30% of cases. Although surgical management has been the treatment of choice for intestinal intussusception in adults, because most frequent causes for adult intussusception are malignant in origin, the importance of the roles of preoperative colonoscopic evaluation has recently been emerging.

CASE SUMMARY

We report an extremely rare case of adult colo-colonic intussusception caused by colonic anisakiasis and successfully treated by endoscopic removal of the Anisakis body. A 59-year-old man visited the emergency department due to 1 day of lower abdominal colicky pain. Abdominopelvic computed tomography (APCT) revealed the presence of mid-transverse colon intussusception without definite necrosis, which was possibly related with colorectal cancer. Because there was no evidence of necrosis at the intussusception site, a colonoscopy was performed to target the colonic lesion and obtain tissue for a histopathological diagnosis. An Anisakis body was found when inspecting the suspicious colonic lesion recorded by APCT. The Anisakis body was removed with forceps assisted by colonoscopy. The patient’s symptoms improved dramatically after removing the Anisakis. A reduced colon without any pathological findings was seen on the follow-up APCT. Without any further treatment, the patient was discharged 5 d after the endoscopy.

CONCLUSION

When colonic intussusception without necrosis occurs in an adult, physician should consider a colonoscopy to exclude causes cured by endoscopy.

Keywords: Intussusception; Anisakis; Colonoscopy; Case report

Core tip: We report an extremely rare case of adult colo-colonic intussusception caused by colonic anisakiasis and successfully treated by endoscopic removal of the Anisakis body. When colonic intussusception occurs in an adult patient and there is no evidence of necrosis of the colon, it is necessary to consider a colonoscopy to exclude causes that can be cured by endoscopy.