A Rare Cause of Intestinal Obstruction Successfully Treated at Bombay Gastro & Cancer Institute, Bathinda
An 88-year-old male presented to the emergency department with severe abdominal pain, progressive abdominal distension, constipation, and inability to pass stools or flatus, suggestive of acute intestinal obstruction.
An urgent CT scan of the abdomen revealed adult colocolic intussusception, a rare condition in which one segment of the colon telescopes into another, resulting in bowel obstruction. Unlike pediatric intussusception, adult colocolic intussusception is uncommon and is frequently associated with an underlying malignant lesion.
Emergency Surgical Management
Considering the patient's advanced age and complete intestinal obstruction, emergency exploratory laparotomy was performed without delay by Dr. Raman Garg, Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda.
Intraoperatively, right-sided colocolic intussusception was confirmed. An oncological Right Hemicolectomy with Primary Ileotransverse Anastomosis was successfully performed to relieve the obstruction while ensuring complete removal of the diseased bowel according to standard colorectal cancer surgery principles.
Histopathology Findings
Histopathological examination of the resected specimen revealed a well-differentiated adenocarcinoma of the colon (Stage pT3N0) arising from a sessile colonic polyp, which served as the lead point for the intussusception. The tumor had invaded through the bowel wall without lymph node metastasis.
Postoperative Recovery
Despite being 88 years old, the patient made an excellent postoperative recovery:
- Early return of bowel function.
- Gradual resumption of oral diet.
- No major postoperative complications.
- Discharged in satisfactory condition on the 7th postoperative day.
Why This Case Is Special
Adult colocolic intussusception is an uncommon surgical emergency and, unlike childhood intussusception, usually has an identifiable pathological lead point. In the colon, the underlying cause is malignant in most patients.
This case is noteworthy because:
- Emergency colorectal surgery was successfully performed in an 88-year-old patient.
- The bowel obstruction was caused by the rare entity of adult colocolic intussusception.
- The underlying pathology was an occult well-differentiated colon adenocarcinoma arising from a sessile polyp.
- Timely surgical intervention relieved the obstruction and achieved definitive oncological treatment in a single operation.
This case highlights the importance of maintaining a high index of suspicion for malignancy in adult intussusception and demonstrates that timely surgery can provide excellent outcomes even in elderly patients.
Advanced Colorectal Cancer and Emergency GI Surgery by Dr. Raman Garg
Dr. Raman Garg is a leading Surgical Gastroenterologist in Bathinda, with expertise in colorectal cancer surgery, emergency intestinal obstruction surgery, oncological bowel resections, and complex abdominal surgery in patients of all ages, including the elderly.
Patients from Bathinda, Punjab, Haryana, Rajasthan, and neighbouring states seek treatment from Dr. Raman Garg for advanced gastrointestinal and colorectal cancer surgical care.
Patient: 88-year-old Male
Diagnosis: Acute Intestinal Obstruction due to Adult Colocolic Intussusception; Well-Differentiated Adenocarcinoma of Colon (pT3N0)
Procedure Performed: Emergency Exploratory Laparotomy, Right Hemicolectomy with Primary Ileotransverse Anastomosis
Operating Surgeon: Dr. Raman Garg, Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon, Bombay Gastro & Cancer Institute, Bathinda
Outcome: Uneventful postoperative recovery; discharged on the 7th postoperative day.
About Dr. Raman Garg
Dr. Raman Garg is a Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic and HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda. He specializes in gastrointestinal cancer surgery, liver, pancreas and bile duct surgery, colorectal surgery, hernia surgery, upper GI surgery, emergency abdominal surgery, and advanced minimally invasive procedures.
Patient identity has been withheld to maintain confidentiality. This case is shared for educational purposes with appropriate consent and privacy safeguards.
