Colo-colic intussusception secondary to colon lipoma: A case report

Abstract

Introduction and importance: Intestinal intussusception is rare in adults and it is associated with lead points affecting the colon in around 17% of patients. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Indeed, the incidence of intestinal intussusception is much rare when caused by lipomas.

Case presentation: Our patient is a 29-year-old male, previously healthy and admitted for severe right lower quadrant abdominal pain of 2-day duration. Computed tomography (CT) scan of the abdomen and pelvis showed large mass of fat consistency containing colon structure.

Clinical discussion: Urgent laparotomy was opted during which colo-colic intussusception was diagnosed and right hemicolectomy with primary ileocolic anastomosis was performed. Pathology report showed that intussusception was induced by a colon lipoma. Patient had an uneventful hospital stay and was discharged on post-operative day 5.

Conclusion: Thus we recommend that colo-colic intussusception caused by lipoma be considered in the differential when diagnosing adults with right lower quadrant pain.

Keywords: Case report; Colo-colic intussusception; Colon lipoma; Lebanese.

Fig. 1

CT scan axial cut showing intra-luminal mass of ascending and transverse colon with thickening of ileo-cecal valve.

Fig. 2

Gross examination of the resected colon measuring 28 × 14 × 8 cm with protruding soft tissue mass measuring 12.5 × 8 × 5 cm showing the site of intussusception marked by the (Black Arrow). Also it shows the attached appendix marked by the (Yellow Arrow) measuring 5 × 0.5 cm.

Fig. 3

Microscopic view (x4) showing lipoma present in promixity to the intussussepted colon. A letter shows the adipose tissue and B letter shows the mucosa corresponding to the colon.

Fig. 4

CT scan axial cut showing the sausage- appearance of intussusception as marked by the (Arrow).