Ileal lipoma causing ileo-ileocolic intussusception

Abstract

Intussusception is one of the most common pediatric surgical emergencies. While most cases are idiopathic, some are caused by a pathologic lead point (PLP). Lipoma is a rare PLP in intussusception, particularly among pediatric patients. We present a case of an otherwise healthy three year old boy, who presented with three days of abdominal pain, vomiting, and worsening abdominal distension. An ileocolic intussusception was diagnosed on ultrasound and underwent an unsuccessful air enema reduction. At exploratory laparotomy, he had an irreducible intussusception with a lead point requiring a small bowel resection. The pathology report demonstrated a 1.4cm submucosal lipoma as the likely lead point. His post-operative care was uneventful, and he was discharged to home on post-operative day four, and is doing well.

Keywords

• Pediatric surgery
• General surgery
• Intussusception