A case report of intestinal acute intussusception secondary to a lipoma: Imagery has a great value

• Published in: International journal of surgery case reports 2024-03, Vol.116, p.109395, Article 109395
• Main Authors: Atri, Souhaib, Debiche, Ahmed, Sebai, Amine, Eya, Azouz, Haddad, Anis, Kacem, Montassar
• Format: Article
• Language: English
• Subjects: Acute intestinal intussusception; Adult; Case report; Ileocecal intussusception; Lipoma
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109395

Acute intestinal intussusception (AII) in adults, unlike in children, is a rare manifestation that is frequently secondary to malignant or benign tumors and intestinal intussusception on a lipoma is more exceptional. We present a rare case of AII caused by a lipoma in a previously healthy 44-year-old man. He experienced severe right lower quadrant pain and constipation. An abdominal CT scan revealed ileocecal intussusception, displaying the classic “sandwich” and “cocarde” images. Additionally, a Caecal lipoma was identified. The patient underwent midline laparotomy, revealing significant small bowel distention upstream of the ileocolic intussusception. Subsequently, a right hemicolectomy with ileocolostomy was performed. Pathological examination confirmed colonic ischemic necrosis attributed to AII originating from a submucosal caecal lipoma. AII is a rare cause of abdominal pain and accounts for 1 to 5 % of adult intestinal obstructions. In adults, an organic cause is found in 70 to 90 % of cases, often secondary to an endoluminal lesion of malignant nature. Pure colonic intussusception on a lipoma is exceptional. CT scan, can show characteristic images and confirms the fatty nature of the lipoma. Surgical intervention is necessary as treatment for intussusception and anatomopathological examination is required for diagnostic confirmation. Intestinal intussusception caused by an intestinal lipoma is rare. Imaging, mainly ultrasound and CT scan, plays a crucial role in providing a positive and etiological diagnosis of the condition by showing characteristic images. Treatment is always surgical, and there is no place for reduction under radiological control. •Acute intestinal intussusception in adults is unusual and has diverse etiologies. Furthermore lipomas are rare in the digestive tract, and intestinal intussusception on a lipoma is more exceptional.•Clinical manifestations appear when lipomas reach a certain size. The symptoms are nonspecific, often presenting as subocclusion, acute obstruction, or nonspecific abdominal syndromes.•CT scan increases diagnostic sensitivity by demonstrating the pathognomonic features of intussusception. It can diagnose the obstructive syndrome, its mechanism, precise localization, and signs of intestinal compromise, and it can identify the cause.•Surgical intervention is necessary as anatomopathological examination is required for diagnostic confirmation.•Reduction under radiological control using hyperpressure is not re