Rectoanal intussusception presenting as prolapsed anal mass

INTRODUCTION: Rectoanal intussusception is an invagination of the rectal wall into the lumen of the rectum. It is very rare to present as mass protruding from the anus. METHODS: We report a case of very rare presentation of adult rectoanal intussusception. CASE REPORT A 54 years-old healthy lady with presenting complain of mass protruding from the anus and per rectal bleeding for one day prior. Clinical examination revealed prolapsed anal mass with carpet like polyp and abundance of mucus discharge. There was no abdominal mass or tenderness. Mass was successfully reduced manually. Colonoscopy showed polypoidal growth at the rectum at 8cm from anus and biopsy was taken. we proceed with low anterior resection and intraoperatively noted rectoanal intussusception. Histopathological examination did showed tubullovilious adenoma with low grade dysplasia. Post-operative course complicated with anastomotic leak which required laparotomy, washout and drainage. She was then discharged well on post-operative day 13. CONCLUSION Rectoanal intussusception can present as prolapse through the anus in adults on rare occasions and should be investigated before definitive treatment. To preserve sphincter function, an initial reduction of colorectal intussusception should be attempted before surgery

Short-term outcomes of surgery in elderly patients with colorectal cancer

Background: Surgery remains the mainstay of treatment for colorectal cancers. The implications of the use of surgery in elderly patients are not clear. Aim: To assess the effect of surgery on short-term outcomes in elderly patients with colorectal cancer. Methods: Colorectal cancer patients undergoing surgical resection from December 2017 - September 2022 were identified from charts and retrospectively examined. Patients were grouped using a cut-off of 65 years into two groups. Demographic and clinicopathological variables, surgery type, and short-term outcomes were compared between the two groups. Results: One hundred six patients were included in the study (55 age <65 and 51 age≥ 65). The two groups were similar in the patient’s characteristics. In the elderly group, the median age was 72 years,(65 to 94 years). The mean number of in-hospital days and major complication rate did not differ between groups (p=0.24; p=0.83, respectively). In elderly patients, the 30-day postoperative mortality rate was 12% as compared to 0% in younger patients (p = 0.009). On univariate analysis, the only factor associated with 30-day postoperative mortality was advanced age (p = 0.01). Limitations: This study was limited because of its retrospective nature and single center Conclusion: According to our study, colorectal cancer patients over the age of 65 who undergo surgery have considerably higher mortality rates related to their advanced age. To develop a complete CRC treatment strategy, one of the elements we must consider is aging