Intussusception-induced acute abdomen caused by a giant lipoma in the transverse colon: a rare case report

Abstract

Introduction: Intussusception is a common finding among children. Conversely, it is infrequent in adults. Colonic lipomas are generally clinically silent making them a very rare etiology of intussusception. Presentation of case: The authors present a case of a 48-year-old male who presented to the emergency department suffering from severe abdominal pain. Following examination and investigations, a giant lipoma (GL) in the transverse colon was identified via ultrasound which showed the classical “target sign”. Clinical discussion: Intussusception among adults is unusual as it accounts for only 1% of bowel obstruction cases. Being colo-colonic makes it even more unlikely since it occurs only in 17% of intestinal obstruction cases. GLs exceeding 5 cm in size can present with a variety of symptoms. Intussusception is an uncommon presentation of a GL. Preoperative diagnosis of GL-induced intussusception is highly improbable and surgical resection is the treatment of choice. Conclusion: Despite the dominance of the asymptomatic presentation of lipomas, considering its diagnosis in the case of an intussusception-induced acute abdomen should cross physicians’ minds.

A Colonic Lipoma Causing Obstruction: A Case Report and Review of Literature

“…Computed tomography scans are considered the best diagnostic tool when it comes to colonic lipomas, while colonoscopies can reveal various signs, such as the cushion sign, that can aid the diagnosis [ 5 ]. In our case, although no malignant signs were detected during colonoscopy and the biopsy results indicated a benign lesion, the increase in the thickness of the colon in CT scans prompted apprehension regarding the potential presence of malignancy.…”

“…Additionally, the lesion was also located in the descending colon, as was in our case, and the CT findings disclosed mural thickening suggestive of neoplastic aetiology [ 12 ]. In other cases, the authors have decided to conduct radical colectomies because malignancy could not be excluded or the biopsy results showed no specific diagnosis [ 5 , 6 , 9 , 15 , 17 , 19 ].…”