Prolapsed giant sigmoid lipoma: a rare cause of adult ischaemic intussusception

Abstract

SUMMARYIntussusception is a rare cause of obstruction in adults and has a variable, non-specific presentation. Adult intussusception is usually associated with an underlying organic pathology, such as a benign or malignant tumour which acts as the lead point. Prolapse of the lead-point mass through the anal canal is an extremely rare presentation with very few reported cases in the literature. We describe a case of a 67-year-old man who presented with rectal prolapse of a large soft tissue mass. CT of the abdomen and barium enema revealed partial intussusception of an upper sigmoid lipomatous polyp. Examination under anaesthesia was performed and the prolapse reduced. A laparoscopic sigmoid colectomy was planned. The patient subsequently re-presented clinically unwell with a recurrent necrotic prolapsing mass. Laparotomy and sigmoid colectomy was performed and the patient recovered fully. The resected mass was a 7×4.5×4.0 cm necrotic sigmoid lipoma. BACKGROUND

Giant Sigmoidal Lipoma Protruding Through Anal Canal and Causing Sigmoido-rectal Intussusception

“…Of these, one was treated with laparotomy, reduction, colostomy, and lipectomy while the other with laparotomy plus sigmoidal colon resection. 3,4 In the present case, we performed transanal resection, and intussusception resolved spontaneously during the follow-up. Transanal simple resection is the safe and reliable treatment method in benign lesions leading to intussusception originating from rectosigmoid junction.…”

“…Moreover, it is extremely rare for the distally located lipomas to cause sigmoido-rectal intussusception and protrude through the anal canal. 3,4 Herein, the diagnosis and treatment of an elderly female patient with a giant lipoma protruding through anal canal leading to sigmoido-rectal intussusception are presented.…”

Adult Ileocolic Intussusception Secondary to Cecal Lipoma: A Case Report

“…These obstructive symptoms are different from the typical abdominal pain, currant jelly stools, and a palpable tender mass common among children with intussusception [9]. Overall, intussusception is responsible for between 1% and 5% of bowel obstructions in adults [10].…”

“…After hyperplastic and adenomatous polyps, lipomas are the third most common benign tumor in the large intestine, with an incidence of 4.4% [11,12]. Within the large intestine, 19% of colonic lipomas are in the cecum, though the incidence of adult lipomas arising within the cecum of the large intestine is 0.836% [10,13]. Lipomas in the colon occur most commonly in women in their fifth and sixth decades of life, with a male-to-female incidence ratio of 1:5 [1,5].…”