ABSTRACT
Colonic duplication is a rare congenital anomaly that is often diagnosed in childhood, but may go unrecognised until adulthood. It often presents with chronic abdominal pain and constipation, and the preoperative diagnosis may be difficult. We present a case of sigmoid duplication in a 33-year-old Indonesian woman who presented with right-sided colicky abdominal pain and vomiting. Clinical examination was unremarkable and radiological investigations raised the possibility of a giant colon diverticulum. The patient underwent exploratory laparotomy that revealed a tubular sigmoid duplication. A sigmoid colectomy with end-to-end anastomosis was performed. She was discharged a week later and remained well at 1 year follow-up. Colon duplications rarely present in adult life and the accurate diagnosis is often made at laparotomy.
Subject(s)
Colectomy/methods , Colon, Sigmoid/surgery , Colonic Diseases/surgery , Adult , Anastomosis, Surgical/methods , Colon, Sigmoid/abnormalities , Colonic Diseases/congenital , Colonic Diseases/diagnosis , Diagnosis, Differential , Female , Humans , Laparotomy , Tomography, X-Ray ComputedABSTRACT
Adult intussusception represents only about 5% of all intussusceptions and is usually caused by a malignant small bowel lesion acting as the apex of intussusception. We report an unusual case in a male patient of adult intussusception caused by a lipomatous lesion located in the terminal ileum, very close to the ileocecal valve, acting as the lead point. After repeated admissions to several hospitals for investigation of nonspecific abdominal symptoms, the possibility of intussusception was finally raised by a computed tomography (CT) scan of the abdomen. The patient underwent a limited right hemicolectomy, which achieved long-lasting cure of his symptoms. This case highlights the difficulties of diagnosing adult intussusception promptly, and the fact that it can also be caused by a benign lesion.
