Ileocecal Intussusception With Lipoma as a Lead Point Leading to Small Bowel Obstruction in an Elderly Male: A Case Report

Abstract

Intussusception with a lipoma as a lead point and associated bowel obstruction is very uncommon in adults. The patient presents with abdominal pain and intermittent or sudden intestinal obstruction requiring surgical intervention. We report the case of a 68-year-old male who presented with complaints of severe abdominal pain, nausea, vomiting, and constipation. A CT scan revealed ileocecal intussusception with a lipoma as a lead point. Evidence of small bowel obstruction and ascites was also noted on imaging. The patient underwent an ileocecal resection followed by an ileocolic side-to-side anastomosis. Pathological examination of the specimen revealed two adjacent submucosal lipomas with focal mucosal ischemic hemorrhagic changes of the large distal lipoma. We present this case owing to its rarity and believe that it will serve to broaden the horizon of research regarding intussusceptions secondary to submucosal lipomas.

Submucosal Lipoma-Induced Small Bowel Intussusception: A Case Study of Surgical Intervention and Management in an Adult Female

“…The male patient was 50 years old and had a history of psoriasis and hypertension. In contrast, the female was 39 years old with no comorbidity [8]. The male experienced symptoms for one day compared to three days in the female, possibly influencing the degree of bowel ischemia observed amid surgery.…”

“…The male's resected bowel loop measured 13 x 5 cm with a connected mesentery of 13 x 3 x 2 cm and a 24 cm intussuscepted portion. At the same time, the female's case included a resected bowel loop measuring 6 x 5 cm, followed by ileoileal anastomosis, showing particular inclusion of the ileum [8]. Despite these contrasts, both cases uncovered comparative pathological findings of ischemic changes, ulceration, congestion, and submucosal lipoma at the lead point of intussusception, highlighting the part of submucosal lipomas in adult intussusception and the need for timely surgical intervention.…”

“…Both patients exhibited side effects consistent with small bowel intussusception, a moderately uncommon condition in adults regularly accelerated by a lead point such as a submucosal lipoma. Both presented to the emergency department with diffuse abdominal pain and multiple episodes of non-bloody, non-bilious vomiting, with diffuse tenderness on physical examination but without signs of peritoneal irritation [8]. The CT imaging in both cases was essential in diagnosing the intussusception, uncovering a lead point caused by a submucosal lipoma, and showing bowel obstruction with edematous, dilated bowel but no free intraperitoneal air or fluid collection [8].…”

“…Both presented to the emergency department with diffuse abdominal pain and multiple episodes of non-bloody, non-bilious vomiting, with diffuse tenderness on physical examination but without signs of peritoneal irritation [8]. The CT imaging in both cases was essential in diagnosing the intussusception, uncovering a lead point caused by a submucosal lipoma, and showing bowel obstruction with edematous, dilated bowel but no free intraperitoneal air or fluid collection [8]. Surgery was required in both cases, including resection of the affected bowel segment followed by anastomosis [8].…”

“…The CT imaging in both cases was essential in diagnosing the intussusception, uncovering a lead point caused by a submucosal lipoma, and showing bowel obstruction with edematous, dilated bowel but no free intraperitoneal air or fluid collection [8]. Surgery was required in both cases, including resection of the affected bowel segment followed by anastomosis [8]. Postoperative recovery was uneventful, with effective nasogastric tube removal on day two, progression to a soft diet on day three, flatus and stool passed on day three, and discharge from the hospital on day five.…”