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Open Access Case report

Pedunculated lipoma causing colo-colonic intussusception: a rare case report

Ouadii Mouaqit13*, Hafid Hasnai1, Leila Chbani2, Abdelmalek Oussaden1, Khalid Maazaz1, Afaf Amarti2 and Khalid Ait Taleb1

Author Affiliations

1 Surgery Departement, University Hospital Hassan II, BP 1893; Km 2.200, Sidi Harazem Road, Fez 30000, Morocco

2 Departement of Pathology, University Hospital Hassan II, BP 1893; Km 2.200, Sidi Harazem Road, Fez 30000, Morocco

3 46, Avenue Ibn el Khatib, Immeuble 46, Lotissement Ghazali, Quartier elAzhar, Fes, Morocco

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BMC Surgery 2013, 13:51  doi:10.1186/1471-2482-13-51

Published: 30 October 2013

Abstract

Background

Intussusception is a relatively common cause of intestinal obstruction in children but a rare clinical entity in adults, representing fewer than 1% of intestinal obstructions in this patient population. Colonic lipomas are uncommon nonepithelial neoplasms that are typically sessile, asymptomatic and incidentally found during endoscopy, surgery, or autopsy.

Case presentation

A 55-year old man visited our emergency department with severe abdominal pain, multiple episodes of vomiting, abdominal distension. Abdominal ultrasound sonography and computed tomography showed a sausage-shaped mass presenting as a target sign, suggestive of intussusception. Surgery revealed a hard elongated mass in the right colon wihch telescoped in the transverse colon and caused colo-colonic intussusception. Rhigt hémicolectomy was performed and pathology documented a mature submucosal lipoma of the colon. We describe the difficulties in diagnosis and management of this rare cause of bowel obstruction and review the literature on adult intussusceptions.

Conclusion

A large submucosal lipoma is a very rare cause of colon intussusception that presents as intestinal obstruction in patients without malignancy. CT and magnetic resonance imaging remain the methods of choice for studying abdominal lipomas, particularly those rising into the layers of the colonic wall. Surgical resection remains the treatment of choice and produces an excellent prognosis.

Keywords:
Intussusception; Lipoma; Abdominal computed tomography; Colo-colic; Invagination