A Rare Cause of Colonic Obstruction “Colonic Intussusception”: Report of Two Cases (original) (raw)

Colo-Colonic Intussusception Secondary to a Colonic Lipoma: Report of Two Cases

Journal of Surgery, 2014

Lipomas are the most common mesenchymal benign tumor of the colon. They are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. A lead-point for adult intussusception exists in 90% of cases and is frequently malignant. The diagnosis can be made by colonoscopy, barium enema examination, and by computed tomography. We have reported two cases of submucosal lipoma of the ascending colon with intestinal obstruction. At laparotomy there was an intussusception of ascending colon, and right colectomy was performed.

Adult Colo-Colonic Intussusceptions with Lipoma as the Leading Point- a Case Report

Journal of Evolution of medical and Dental Sciences, 2013

Adult Colo-colonic intussusception is a rare presentation. Colo-colonic intussusceptions presenting as history of diarrhea and occasionally pain abdomen and undiagnosed for 2 months is unusual. We report a case of Colo-colonic intussusceptions diagnosed by USG abdomen and then colonoscopy and further confirmed by laparotomy the cause being a sub mucosal lipoma. DISCUSSION: Intussusception occurs when a segment of bowel (intussusceptum) telescopes into the segment adjacent to it (intussuscipiens). The condition occurs more frequently in children, where enlarged Payer's patches are the most common lead-point for the intussusception. Intussusception in adults is rare, accounting for 5% of all intussusceptions. The intussusception is associated with a pathological lead-point in 90% of cases. (3, 4) Review literature revels majority (58%) of intussusceptions in the large bowel had a malignant lead point (3,). Most often, this was adenocarcinoma, but, lymphoma and leiomyosarcoma were ...

Colonic intussusception caused by colonic lipoma: A case report

Intussusception is a pediatric condition that rarely presents in adults. Colonic lipomas 4 cm and more in diameter can cause colonic intussusception leading to emergency operation. Surgical resection of the involved segment must be the procedure of choice. We report a case of colonic intussusception caused by colonic lipoma in an adult. The patient underwent operation, and histopathological examination of the specimen confirmed the diagnosis of colonic submucosal lipoma.

Intussusception in a young woman caused by a colonic lipoma

Introduction: Intussusception is commonly discussed in the context of children. However in adults, intussusception is an identified diagnosis accounting for 5% of all intussusceptions. A malignant etiology is always suspected in adults; however, rarely as in this case, a benign bowel lesion may be the underlying cause. Case Report: In this case report, we present an unusual case of a 36-year-old female patient with pain in her left lower abdomen with loss of appetite, abdominal distension, and diarrhea lasting three days. Computed tomography scan confirmed the diagnosis of intussusception. A lipoma of the descending colon was the lead point for the intussusception into the sigmoid lumen. Sigmoid colectomy with primary anastomosis was performed. The resected specimen was a yellowish, oval, and broader-based homogeneous tumor, 4x4x3 cm in size, rising from the submucosal layer of the colonic wall. Conclusion: While an intussusception is clinically nonspecific, intestinal obstruction is usually found to be the common presentation. This case highlights the fact that adult intussusception though usually associated with malignancy in 2/3 of cases, a benign lesion may also rarely cause adult intussusception. Colonic lipomatosis, though only accounting for 0.035–4.4% of all polypoid lesions in the colon, should kept in mind as one of the uncommon causes for intussusception in adults.

Colonic intussusception by a giant colon lipoma: A case report

International Journal of Surgery Open

Introduction: Colonic lipomas are extremely rare, and they can mimic clinical manifestations of a colonic carcinoma, presenting with bowel obstruction or intussusception. We present a case of a 57-year-old female with a colonic lipoma causing a colonic intussusception. A review of the literature is also included. Presentation of case: A 57-year-old female patient arrived to the emergency department with bowel obstruction. Imaging studies revealed intussusception triggered by a colonic pediculate lipoma. A left colectomy was performed and the patient had an uneventful recovery. Discussion: Two-thirds of colonic intussusceptions are associated with malingnant tumors. There are several therapeutic interventions for the treatment of this disease, which include a segmental colectomy, local excision and even endoscopic removal. Colonic lipomas are extremely rare, and they can mimic a malignant tumor, so it is imperative for the surgeon to rule out a malignancy in order to opt for a more conservative or minimal approach. Conclusion: If the diagnosis of a benign disease is uncertain in patients presenting with colonic intussusception, then it should be managed as a malignant lesion due to the higher incidence of large bowel adenocarcinomas presenting with this disease.

Colonic intussusception caused by a sigmoidal lipoma: A case report

International Journal of Surgery Case Reports, 2018

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.

Pedunculated lipoma causing colo-colonic intussusception: a rare case report

BMC Surgery, 2013

Background: Intussusception is a relatively common cause of intestinal obstruction in children but a rare clinical entity in adults, representing fewer than 1% of intestinal obstructions in this patient population. Colonic lipomas are uncommon nonepithelial neoplasms that are typically sessile, asymptomatic and incidentally found during endoscopy, surgery, or autopsy. Case presentation: A 55-year old man visited our emergency department with severe abdominal pain, multiple episodes of vomiting, abdominal distension. Abdominal ultrasound sonography and computed tomography showed a sausage-shaped mass presenting as a target sign, suggestive of intussusception. Surgery revealed a hard elongated mass in the right colon wihch telescoped in the transverse colon and caused colo-colonic intussusception. Rhigt hémicolectomy was performed and pathology documented a mature submucosal lipoma of the colon. We describe the difficulties in diagnosis and management of this rare cause of bowel obstruction and review the literature on adult intussusceptions.

A case of colonic intussusception and obstruction secondary to giant colonic lipoma

Journal of Surgical Case Reports, 2020

Lipomas are benign soft tissue tumors found throughout the body including the gastrointestinal (GI) tract. Colonic lipomas are typically asymptomatic, incidentally identified during endoscopy or at the time of autopsy. However, giant lipomas larger than 4 cm usually manifest symptoms such as abdominal pain, obstruction, melena or intussusception. The transverse colon is the least common location for colonic lipoma. We report on a 54-year-old man with acute large bowel obstruction secondary to a long segment colo-colonic intussusception from a giant lipoma originating in the transverse colon. The diagnosis was suggested by advanced imaging and confirmed on endoscopy. He was treated successfully by laparoscopic extended right hemicolectomy with ileocolonic anastomosis. This case highlights the complexity of presentation and surgical management of large bowel obstruction and colonic intussusception, as well as the rare entity of giant colonic lipoma.