Large pedunculated colonic lipoma: a rare cause of colorectal intussusception in adults

• Published in: The Pan African medical journal Vol. 36; no. 200; p. 200
• Main Authors: Zenaidi, Hakim, Ismail, Imen Ben, Rekik, Fatma, Aziz, Mouelhi, Rebii, Saber, Zoghlami, Ayoub
• Format: Journal Article
• Language: English
• Published: Uganda The African Field Epidemiology Network 21-07-2020; The Pan African Medical Journal
• Subjects: bowel obstruction; Case Report; Colonic Neoplasms - complications; Colonic Neoplasms - diagnosis; colorectal resection; Humans; intussusception; Intussusception - diagnosis; Intussusception - etiology; Intussusception - surgery; Laparotomy; lipoma; Lipoma - complications; Lipoma - diagnosis; Male; Middle Aged; Rectal Neoplasms - complications; Rectal Neoplasms - diagnosis; Tomography, X-Ray Computed; colorectal resection; intussusception; Lipoma; bowel obstruction
• ISSN: 1937-8688; 1937-8688
• DOI: 10.11604/pamj.2020.36.200.24606

Colo-rectal intussusception is rare in adults and is often secondary to malignant lesions, rarely benign lesions such as colonic lipomas can also be the cause. We present the case a 60-year-old man who presented to the emergency department with acute abdominal pain. On physical examination, the abdomen was distended with diffuse tenderness. CT scan of the abdomen revealed a colo-rectal intussusception secondary to a rectal lipoma with parietal pneumatosis of the invaginated loop. An emergency laparotomy was performed. Intraoperatively the radiological findings were confirmed. A rectosigmoid resection (Hartmann's procedure) taking off the lipoma and the invaginated segment of the colon was performed and the patient had an unevent full recovery. Histopathology confirmed a 6cm sub-mucosal lipoma without evidence of malignancy. As the diagnosis of a benign disease in patients presenting with colonic intussusception can only be made on pathological examination, this entity should be managed as a malignant lesion due to the high incidence of malignancy.