Adult Sigmoid Colo-colic Intussesception Due to Polypoidal Lipoma: A Rare Case Report
Rahul Jain *
Department of General Surgery, Maulana Azad Medical College, New Delhi, India.
Dharmender Aggarwal
Department of General Surgery, Maulana Azad Medical College, New Delhi, India.
Vidhya Gunasekaran
Department of General Surgery, Maulana Azad Medical College, New Delhi, India.
Sushanto Neogi
Department of General Surgery, Maulana Azad Medical College, New Delhi, India.
Ruchi Jain
Department of Obstetrics and Gynecology, Vardhaman Mahavir Medical College, New Delhi, India.
*Author to whom correspondence should be addressed.
Abstract
Aim: Intussusception is defined as invagination or telescoping of proximal bowel loop (intussusceptum) into distal loop (intussuscepiens). More than 90% of adult colonic intussusceptions are associated with a mass acting as lead point. It is required for all treating surgeons to know about presentation and management of adult intussusception.
Case Report: A 40 year old man presented with pain in left iliac fossa and obstipation. Ultrasonography reveals target sign in left iliac fossa and CT scan showed sigmoid colo-colic intussusception with polypoidal submucosal lipoma as lead point. Patient was managed with en bloc resection and anastomosis in continuity.
Discussion: Intussusceptions are very rare in adult population and less than 50 cases has been reported till now of colo-colonic intussusception with lipoma as lead point. About 60% of adult colonic intussusception are caused by malignant growth. CT scan is able to diagnose correctly in about 95% cases and role of colonoscopy is debatable for reduction of intussusception.
Conclusion: Although rare, pathophysiology of adult intussusception should be understood clearly for proper management. Early CT scan should be used in doubtful cases to diagnose intussusception.
Keywords: Adult intussusceptions, submucosal lipoma, colo-colonic intussusception