Intraluminal Submucosal Lipoma as a Lead Point Causing Colo-colic Intussusception: A Case Report

Abstract

Adult colo-colic intussusception is very rare and it poses a diagnostic challenge in the geriatric population. The clinical diagnosis can be difficult due to non specific presenting complaints. However, it is a surgical emergency with high morbidity and mortality rates. Surgical exploration is the recommended treatment as most cases involve a pathological lead point. In this case report, the authors present the case of a 50-year-old female patient who complained of pain in the left lumbar region, loose stools, and loss of appetite for one month. Ultrasound (US) revealed an echogenic mass with a typical bowel within-bowel appearance. Contrastenhanced Computed Tomography (CECT) of the abdomen showed telescoping of the proximal descending colon into the distal descending colon. Additionally, a fat density rounded lesion was observed on CT. The wall of the descending colon exhibited enhancement, indicating viable large bowel loops. Colonoscopy revealed a polypoid growth. The patient subsequently underwent surgery, confirming all imaging findings. Resection and anastomosis of the colon were performed, with an intraluminal lipoma identified as the primary cause of the colo-colic intussusception. The postoperative period of up to three months was uneventful. US and CT play a crucial role in the early diagnosis and prevention of serious complications.

Keywords

• bowel within bowel appearance
• bowel telescoping
• fat density bowel mass
• large bowel obstruction