Abstract
Background: Colonic lipomas are rare and can sometimes cause intussusception. The aim of this review was to define the presentation and possible management for colocolic intussusception caused by colonic lipomas. Methods: A systematic search for patients with colocolic intussusception caused by colonic lipoma, including all available reports up to 2021. Epidemiological, clinical, laboratory, and instrumental data and details about the treatments performed were gathered. Results: Colocolic intussusception caused by lipoma is more frequent in women (57%), occurring between 40 and 70 years of age. Up to 83% of patients report abdominal pain, followed by constipation (18%), rectal bleeding (16%), and diarrhea (12%), with abdominal tenderness (37%), and distension in 16%, whereas 24% have a negative exploration. CT (72%) and colonoscopy (62%) are more commonly able to diagnose the entity. The most common location of intussusception is the transverse colon (28%). The surgical operation varies according to the site. The average dimensions of the lipoma are 59.81 × 47.84 × 38.9 mm3. Conclusions: A correct preoperative diagnosis of colonic lipoma causing intussusception might not be easy. Despite nonspecific clinical and laboratory presentation, cross-sectional imaging can help differential diagnosis. Surgical treatment depends on the localization.
Highlights
Lipomas are nonepithelial benign adipose tumors observed throughout the gastrointestinal tract, most frequently located in the colon [1]
Up to 83% of patients report abdominal pain, followed by constipation (18%), rectal bleeding (16%), and diarrhea (12%), with abdominal tenderness (37%), and distension in 16%, whereas 24% have a negative exploration
In some cases, lipomas may present with symptoms, such as abdominal pain, diarrhea, constipation, the mimicking of colon cancer and, occasionally, intussusception [3]
Summary
Lipomas are nonepithelial benign adipose tumors observed throughout the gastrointestinal tract, most frequently located in the colon [1] These neoplasms present as a sessile polypoid mass, rarely pedunculated, with dimensions ranging from 2 mm to 30 cm. Intestinal intussusception is the invagination of an intestinal loop with a mesenteric fold (intussusceptum) in the lumen of a continuous portion of the intestine (intussuscipiens) following peristalsis [4] In adults, it is rare (1.86 cases/year [5]), and has various clinical presentations compared to the pediatric form (classic triad of abdominal pain, palpable abdominal mass, and hematochezia) [6], making it difficult to diagnose preoperatively, despite the evolution of imaging procedures [7].
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