Ileocolic intussusception caused by a lipoma in an adult

Abstract

Intussusception is rarely observed in adults. Adult cases account for only 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction cases. The etiology, presentation and management of intussusception in adults are different from those in children. The clinical presentation in adults often includes nonspecific signs and symptoms, thereby complicating differential diagnosis from other causes of abdominal pain. We report a 29-year-old Asian woman who visited our emergency department with complaints of fever associated with epigastric pain since one day. Abdominal computed tomography demonstrated ileocolic intussusception, and laparoscopic small bowel luminal mass resection was performed. Histopathology report confirmed a 3.5 cm × 2.7 cm submucosal lipoma in the terminal ileum. Sufficient vigilance and appropriate investigations are important for prompt diagnosis and surgical referral of patients to enable favorable outcomes. A computed tomography scan can be a helpful modality in establishing a diagnosis.

Keywords: Adult intussusception; Computed tomography; ILeocolic; Laparoscopic surgery; Lipoma.

Figure 1

Axial (A) and coronal (B) view of abdominal computed tomography scans demonstrated an ileocolic intussusception with diffuse wall thickening of the ascending and transverse colon. The entrance of the ileal segment into the colon is shown (arrow).

Figure 2

Axial (A) and coronal (B) plain abdominal computed tomography scans demonstrate a well-circumscribed, intraluminal hypodense mass with fat attenuation in the terminal ileum (arrow).

Figure 3

Laparoscopic view. The ileum was invaginated at the colon (arrow).