Lipoma induced jejunojejunal intussusception

Abstract

Intussusception in adults is rare. The clinical picture of intussusception in adults is subtle and the diagnosis is, therefore, elusive. The presence of a structural abnormality in the great majority of the adult cases mandates high clinical suspicion. Gastrointestinal lipomas are rare benign tumors and intussusception due to a gastrointestinal lipoma constitutes an infrequent clinical entity. The present report describes a case of jejunojejunal intussusception in an adult with a history of severe episodes of hematochezia and colicky upper abdominal pain. The diagnosis was suspected preoperatively but computed tomography scan could not rule out malignancy. Exploratory laparotomy revealed jejunojejunal intussusception secondary to a lipoma which was successfully treated with segmental intestinal resection.

Jejunojejunal intussusception secondary to submucosal lipoma resulting in a 5-year history of intermittent abdominal pain

“…Other useful modalities for small bowel evaluation are push or double balloon enteroscopy and video capsule endoscopy,6 but have limited usage in cases of obstruction. Barium studies and abdominal ultrasound may show classic signs of intussusception but have limited sensitivity for diagnosing intussusception when compared to CT scan.…”

“…In contrast to colonic intussusceptions, where all should be resected en block without reduction, a selective approach can be applied for small bowel cases. Reduction should not be attempted where signs of bowel ischaemia and inflammation are present or malignancy is suspected due to fears of tumour seeding 6. Small bowel lipomata are usually solitary but may be multiple in up to 5% of cases;3 careful examination of the rest of the bowel is prudent to rule out other lesions not detected on preoperative imaging.…”

Adult ileoileal intussusception induced by an ileal lipoma diagnosed preoperatively: report of a case and review of the literature

“…The locations of the lesions were as follows: 2 cases had lesions in the stomach, 4 were in the jejunum, 21 were in the ileum, 3 were in the cecum, 7 were in the ascending colon, 6 were in the transverse colon, 4 were in the descending colon, and in 3 cases, the lesion was located in the sigmoid colon. In the small intestine, such lesions are most commonly located in the ileum (84%, 21 of 25 patients), while the jejunum is the least common site for small intestinal lipomas [14]. The lipoma size ranged from to 1.2 to 12.0 cm, with a mean size of 4.9 cm.…”

“…Abdominal CT is the most sensitive radiological method for confirming a diagnosis of intussusception [13,14], with the most frequent finding on plain abdominal radiographs being a mass of low-density tissue with or without signs of concomitant intestinal obstruction [15]. On the other hand, intussusception on US invariably appears as a sausage-shaped mass consisting of concentric rings when the scan plane is parallel to its longitudinal axis, which makes a target sign-like mass when the scan plane is perpendicular to its longitudinal axis [16,17].…”

Adult jejunojejunal intussusception caused by metastasized pleomorphic carcinoma of the lung: Report of a case

“…Malignant causes include primary small bowel tumors and secondary intestinal metastases of other tumors. [6][7][8][9][10][11] We report a case of adult small bowel intussusception caused by jejunal metastasis of primary sarcomatoid carcinoma of the lung.…”