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. 2011 Sep 12:5:452.
doi: 10.1186/1752-1947-5-452.

Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

Avdyl S Krasniqi  1 , Astrit R Hamza, Lulzim M Salihu, Gazmend S Spahija, Besnik X Bicaj, Selvete A Krasniqi, Fisnik I Kurshumliu, Lumturije H Gashi-Luci
Affiliations

Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

Avdyl S Krasniqi et al. J Med Case Rep. .

Abstract

Introduction: The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception.

Case presentation: A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum.

Conclusions: Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.

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Figures

Figure 1
Figure 1
A barium enema image of the colon shows a filling defect in the ascendant colon (arrows).
Figure 2
Figure 2
An abdominal computed tomography scan shows a 'sausage'-shape soft-tissue mass in the ascendant colon and thickened walls of the ileum.
Figure 3
Figure 3
A double intussusception of the ileum after desinvagination from the ascendant colon (thick arrow) and necrotic change in the wall of the ascendant colon (thin arrow).
Figure 4
Figure 4
A pendulant polipoid submucosal tumor of the terminal ileum served as a lead point for the intussusception.
Figure 5
Figure 5
A specimen fixed in formalin shows a submucosal pendulant lipoma (3.5 cm in diameter) that after a histopathology examination was revealed to be benign.
See this image and copyright information in PMC

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