Colocolic Intussusception with Lipoma as Lead Point = إنغلاف قولوقولوني بسبب ورم شحمي

Abstract

A 25-year-old man, with no significant medical or surgical history, presented with a three-week history of left-sided, colicky abdominal pain which was aggravated by eating. It was associated with a four Kg weight loss and per rectum bleeding three days prior to presentation. Clinically, the patient looked well; his vital signs and haemodynamic parameters were stable. His abdomen revealed a mildly tender and mobile mass over the left lumbar area of c. 4 × 5 cm; the rest of the abdomen was soft. The abdominal computed tomography (CT) scan showed a c. 40 × 30 mm intra-mural lipoma in the descending colon with colocolic intussusception [Figure 1A and 1B]. The patient underwent a laparotomy and segmental colonic resection with primary anastomosis. The operative findings of the left colon indentified the presence of a lipoma in the left colon [Figure 2]. The histopathological examination of the mass confirmed the presence of a submucosal ulcerated lipoma. Figure 1 A & B: Coronal view of contrast abdominal CT scan (A) with presence of lipoma (arrow). B: Axial view showing the presence of an intra-mural lipoma in the descending colon with colocolic intussusception (arrow). Figure 2: Operative specimen showing the presence of an oval-shaped lipoma with yellow-reddish discoloration (arrow).