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Intestinal obstruction is a surgical emergency with most cases being small bowel obstruction. Large bowel obstruction is comparatively uncommon and colonic malignancies are a usual cause. Such lesions cause intestinal obstruction by luminal narrowing or rarely serve as lead point of intussusception. Herein, we describe an unusual case of sigmoid carcinoma causing sigmoid-rectal intussusception, rectal prolapse, and eventually large bowel obstruction. Pre-operative CT should be done in all adult large bowel obstruction to look for possible site and cause of obstruction and to rule out malignancy as a cause of obstruction. Conversely, every case of rectal prolapse should be diligently evaluated to rule out intussusception, which if present in an adult indicates a high likelihood of underlying malignancy.

Sigmoid carcinoma with sigmoid-rectal intussusception presenting as rectal prolapse and large bowel obstruction in the ED