BackgroundIntussusception 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 presentationA 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.ConclusionA large submucosal lipoma is a very rare cause of colon intussusception that presents as intestinal obstruction in patients without malignancy. CT and magnetic resonance imaging remain the methods of choice for studying abdominal lipomas, particularly those rising into the layers of the colonic wall. Surgical resection remains the treatment of choice and produces an excellent prognosis.
Intussusceptions in adults is rare. Gastrointestinal lipomas are rare benign tumors and intussusceptions due to a gastrointestinal lipoma constitutes an infrequent clinical entity. Lipoma may develop as a benign tumor in all organs and rarely in large or small intestine. The present report describes a case of jejunojejunal intussusceptions in an adult with a history of colicky upper abdominal pain. Ileo-ileal invagination was diagnosed by computed tomography scan. Exploratory laparotomy revealed jejunojejunal intussusceptions secondary to a lipoma which was successfully treated with segmental intestinal resection. A review of the literature is also performed regarding this rare association revealing the diagnostic and therapeutic debates that exist.Abstract (french)L’invagination chez les adultes est rare. Les lipomes gastro-intestinaux sont de rares tumeurs bénignes et l’invagination intestinale due à un lipome gastro-intestinal constitue une entité clinique trés rare. Le lipome peut se développer comme une tumeur bénigne dans tous les organes et rarement dans l’intestin grêle ou le colon. Le présent rapport décrit un cas d’invagination jéjunojéjunale chez un adulte avec une histoire de douleurs abdominales. Iléo-iléale invagination a été diagnostiquée par tomodensitométrie. Une laparotomie exploratrice a révélé l’existence d’une invagination jéjunojéjunale secondaire à un lipome qui a été traitée avec succès par une résection intestinale segmentaire. Une revue de la littérature est également effectuée au sujet de cette association rare révélant les débats diagnostiques et thérapeutiques qui existent.
Colonic adenocarcinoma revealed by metastatic anorectal fistula is rare, with few cases in the literature. Such lesions can be taken for the more common manifestation of a benign perianal abscess or fistula. Once diagnosed, the management of such conditions remains controversial. We herein report two cases with perianal fistula that were subsequently found to have developed perianal adenocarcinoma on biopsy. Further colonic investigation revealed a rectosigmoid adenocarcinoma. Histology and immunohistochemical staining was identical in both primary and metastatic tumors. Preoperative chemoradiation with further rectal low anterior resection and local excision of metastatic anal fistula was performed. There is no recurrence after 3 years of follow-up.
Purpose: Cavernous haemangiomas of the uterine cervix are very rare and usually harmless. It is a benign tumor that may cause gynecological obstetrical complications. Although it is a benign condition but it can have serious consequences for the mother as well as for the baby. The treatment is often surgical and diagnosis is histological. Methods and Result: we reported a case of cavernous haemangioma of the cervix in a 25-year old multiparous patient, referred to our Centre in the 33 -34 gestational weeks for premature labor with membranes rupture. A 3 cm × 6 cm soft regular purplish red mass is found in the uterine cervix. Tocolosys, prophylactic antibiotic therapy and corticotherapy for fetus pulmonary maturation were then decided after elimination of chorioamniotite signs. Caesarean has been made during labor, a week later, for tumor previa. The tumor excision has been made through the vagina after fetus extraction. The histological examination confirmed diagnosis of the cavernous haemangioma. Discussion: Further to this observation, the clinical, histological and therapeutic characteristics of the cavernous haemangioma unusual presentation were drawn up and literature enriched since this pathology is rare. Most previous reports in the literature consist of single-case histories, and the experience of individual institutions is limited. The patients dramatically present dilemmas in the disease management. This can result in uncontrolled bleeding especially during operative delivery and may require hysterectomy. To avoid unexpected bleeding from haemangioma, patients should be repeatedly examined for haemangioma of the birth canal, and special care should be taken in choosing the delivery mode.
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