M'rabet S, Jarrar MS, Akkari I, Abdelkader AB, Sriha B, Hamila F, Letaief R, Jazia EB. Colonic intussusception caused by a sigmoidal lipoma: A case report.
Int J Surg Case Rep 2018;
50:1-4. [PMID:
30059860 PMCID:
PMC6079477 DOI:
10.1016/j.ijscr.2018.06.009]
[Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/20/2018] [Indexed: 12/14/2022] Open
Abstract
Intestinal intussusception in adults is rare, accounting for approximately 1% of all bowel obstructions.
Colo-colonic intussusception accounts for 17% of cases.
The occurrence of large lipomatous masses as cause of intussusception and semi-obstructive symptoms remains rare.
The case that we describe is particularly unique because apart from being an example of intussusception in adults, it occurred in the sigmoid colon and was not associated with a malignant lesion.
Introduction
Intussusception is a relatively common condition seen in children. In comparison, adult intussusception is rare and is often secondary to inflammatory diseases, benign or malignant tumors and motility disorders. Being a benign cause, lipomas appear as a particularly rare gastrointestinal tumor.
Presentation of Case
We present a case of colo-colonic intussusception secondary to a sigmoidal lipoma, in a 40-year-old man. We describe the different aspects of diagnosis and management of this rare complication.
Discussion
Adult intussusception is the cause of symptomatic bowel obstruction in 1% of cases and its colo-colonic occurrence represents 17% of all intestinal intussusceptions. The case that we describe is particularly unique because apart from being an example of intussusception in adults, it occurred in the sigmoid colon and was not associated with a malignant lesion. The treatment of intussusception in adults is surgical resection because of the high incidence of underlying malignancy. Colonoscopy is a modality which allows direct visualization of the lipoma. However, intraluminal reduction via colonoscopy is not recommended.
Conclusion
Colo-colonic intussusception is a very rare complication of lipoma. It is determined that the treatment is surgical due to the risk of malignancy.
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