Colonic Lipoma Causing Bowel Intussusception: An Up-to-Date Systematic Review

Abstract

Background: Colonic lipomas are rare and can sometimes cause intussusception. The aim of this review was to define the presentation and possible management for colocolic intussusception caused by colonic lipomas. Methods: A systematic search for patients with colocolic intussusception caused by colonic lipoma, including all available reports up to 2021. Epidemiological, clinical, laboratory, and instrumental data and details about the treatments performed were gathered. Results: Colocolic intussusception caused by lipoma is more frequent in women (57%), occurring between 40 and 70 years of age. Up to 83% of patients report abdominal pain, followed by constipation (18%), rectal bleeding (16%), and diarrhea (12%), with abdominal tenderness (37%), and distension in 16%, whereas 24% have a negative exploration. CT (72%) and colonoscopy (62%) are more commonly able to diagnose the entity. The most common location of intussusception is the transverse colon (28%). The surgical operation varies according to the site. The average dimensions of the lipoma are 59.81 × 47.84 × 38.9 mm3. Conclusions: A correct preoperative diagnosis of colonic lipoma causing intussusception might not be easy. Despite nonspecific clinical and laboratory presentation, cross-sectional imaging can help differential diagnosis. Surgical treatment depends on the localization.

Clinicopathological features and management of colonic lipomas

“…As observed in the 3 cases presented earlier, abdominal pain is a commonly encountered clinical finding. A common complication of colonic lipomas is that they may lead to colocolic intussusception, as it is widely reported in the literature [12–15] . Intussusception due to a colonic lipoma usually occurs between ages 40 and 70, observed in lesions >4 cm in diameter, and it is more frequently encountered in women [12,13] .…”

Colonic lipoma of the hepatic flexure causing invagination in an adult

“…The main symptom is abdominal pain in 83% of cases, in addition to bleeding and changes in bowel habits particularly constipation [ 1 , 5 , 6 ]. According to Menegon Tasselli et al ., abdominal tenderness is the most frequent clinical sign in 37% of cases, followed by abdominal distension in 16%.…”

“…Laboratory test results are normal in 61% of cases. Preoperative diagnosis is difficult, and diagnostic imaging studies include radiography, abdominal ultrasound, tomography and colonoscopy [ 6 ]. The most commonly used method is abdominal computed tomography, which has a sensitivity of 87% and specificity of 100%; it detects intestinal invagination as a lesion with the typical appearance known as the ‘Dance sign’ or a soft tissue ‘sausage-shaped’ mass.…”

“…The most commonly used method is abdominal computed tomography, which has a sensitivity of 87% and specificity of 100%; it detects intestinal invagination as a lesion with the typical appearance known as the ‘Dance sign’ or a soft tissue ‘sausage-shaped’ mass. Invagination is confirmed by colonoscopy, which can also detect the lead point [ 3 , 6 ].…”

Colonic Intussusception Due to a Cecal Tumor: A Representative Case

“…Colonoscopy has the added benefit of providing the opportunity for therapeutic reduction [3], but this is not always possible. In the majority of cases in adults, surgery remains the optimal management strategy for the reduction and resection of any underlying neoplastic process [4][5][6].…”