Colo-colonic intussusception due to large submucous lipoma: A case report.
BACKGROUND
Intussusception in adult is rarely caused by idiopathic conditions. Main causes are inflammatory diseases, benign or malignant tumors and motility disorders. As a benign cause, lipomas appear as a particularly rare gastrointestinal intraluminal tumor occurring with highest incidence in the colon, mostly in the caecum and ascending colon.


METHODS
A 57-year-old male patient was admitted at the surgical emergency in Belo Horizonte, with history of chronic and intermittent diffuse abdominal pain, associated with variations of his bowel habits and rare episodes of vomiting starting around 3days prior to admission.


CONCLUSIONS
Intussusception is the cause of adult symptomatic bowel obstruction in 1% of the cases and its colocolonic occurrence represents 17% of all intestinal intussusceptions in adults. The reported case presents itself as even rarer considering its evaluation according to the epidemiological statistics of 1:5 men/women ratio and lipoma's most common location being the right colon. Intussusception and intestinal obstructions caused by intraluminal lipomas are not often described in the literature and its occurrence is directly related to its size, usually larger than 2cm diameter. The management of lipomatous intraluminal lesions of the colon is traditionally surgical, and it allows a selective resection, depending on the size of the tumor, length of intussusception, and the amount of inflammation.


CONCLUSIONS
Patients with chronic abdominal symptoms and semi-obstruction caused by intussusception are rarely diagnosed before surgery unless there is a high index of suspicion. Colonoscopy contributes to diagnosis given that it provides direct visualization and biopsy.
Hospital Felício Rocho, Belo Horizonte, MG, Brazil. Electronic address: luiza.ohasi@uol.com.br.
Luiza Ohasi
LO
de Figueiredo
Department of Surgery, Instituto de Ensino e Pesquisa da Santa Casa, Belo Horizonte, MG, Brazil.
D P C
DPC
Garcia
Department of Surgery, FMUFMG and Instituto de Ensino e Pesquisa da Santa Casa, Belo Horizonte, MG, Brazil.
Luiz Ronaldo
LR
Alberti
Colorectal Surgeon at Hospital Felício Rocho, Av do Contorno 9530, 30110-130, Belo Horizonte, MG, Brazil.
R A
RA
Paiva
FMUFMG and Instituto de Ensino e Pesquisa da Santa Casa, Belo Horizonte, MG, Brazil.
Andy
A
Petroianu
Hospital Felício Rocho, Belo Horizonte, MG, Brazil.
Luiza Barbosa
LB
Paolucci
Hospital Felício Rocho, Belo Horizonte, MG, Brazil.
M R L G
MRLG
Costa
Chronic abdominal pain; Colo-colonic intussusception; Submucous lipoma
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