Surgical management of adult sigmoid colon intussusception caused by a malignant tumor: report of a case

A 67-year-old man was admitted for investigation of bloody stools. The sigmoid colon was found to be intussuscepted into the rectum very close to the anus, making reduction difficult. After dividing the peritoneum, the surgeon inserted his hands below the peritoneal reflection along the rectum and pushed the intussusceptum back from the distal to the proximal rectum using a milking action. The rectum was divided 5 cm from the peritoneal reflection, and the sigmoid colon was divided 10 cm proximally from the intussusception. The proximal end of the sigmoid colon was brought out as a colostomy. The residual rectum and the descending colon were anastomosed 5 months after the first operation. We present a case of adult intussusception of the sigmoid colon caused by a well-differentiated adenocarcinoma, which was successfully treated by manually reducing the intussusception, whereby abdominoperineal resection was avoided.