title: Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma.
abstract: Introduction. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions). Colonic intussusception is even rarer, particularly when caused by lipomas.Case Presentation. A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm) was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage.Conclusion. Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%); since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.
authors.affiliation: Azienda Socio-Sanitaria di Vimercate, Presidio di Carate, Via Mosè Bianchi 9, 20841 Carate Brianza, Italy.
authors.forename: Tiziana
authors.identifier: 0000-0001-5996-3301
authors.initials: T
authors.lastname: Casiraghi
authors.affiliation: Azienda Socio-Sanitaria di Vimercate, Presidio di Vimercate, Via Santi Cosma e Damiano 10, 20871 Vimercate, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Masetto
authors.affiliation: Azienda Ospedaliera di Desio e Vimercate, Presidio di Carate, Via Mosè Bianchi 9, 20841 Carate Brianza, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Beltramo
authors.affiliation: Azienda Ospedaliera di Desio e Vimercate, Presidio di Carate, Via Mosè Bianchi 9, 20841 Carate Brianza, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Girlando
authors.affiliation: Azienda Ospedaliera di Desio e Vimercate, Presidio di Carate, Via Mosè Bianchi 9, 20841 Carate Brianza, Italy.
authors.forename: Camillo
authors.initials: C
authors.lastname: Di Bella