Ileal Lipoma Causing Ileo-Ileal Intussusception: A Case Report

Abstract

Intussusceptions are rare entities among adult and adolescent populations. It is relatively common among children. Due to the lack of specific clinical features in adult and adolescent patients, its diagnosis is often delayed. Adult and adolescent intussusception could be due to many reasons, but malignancy is one of the key causes among them. Thus, unlike in children, adult and adolescent patients need proper evaluation to find the cause of intussusception pre-operatively. Having a pre-operative diagnosis prevents unnecessary bowel resections. It also helps not to miss a malignancy and to carry out the correct surgery. Intestinal lipoma is a rare entity that could cause intussusception among adults and adolescents. But most of the lipoma does not cause any symptoms and may only find during a post-mortem following an unrelated death. Intestinal lipomas are benign lesions that can occur anywhere in the gastrointestinal tract. A quarter of intestinal lipomas occur in the small intestine. Among those lipomas, 90% arise from the submucosa of the intestine. Here we report a 17-year-old boy presented to the surgical clinic with progressively worsening colicky abdominal pain. Further imaging revealed an ileal lipoma causing intussusception. The patient was treated with laparoscopy-assisted ileal segment resection and primary anastomosis. He made an uneventful recovery. Histology confirmed the diagnosis of a lipoma and it was arising from the subserosa of the intestine, making it a rare type of lipoma. Since lipomas are benign lesion patient did not need any follow-up after the surgery. The case presented here is the first documented case in Sri Lanka of ileo-ileal intussusception as a result of a subserosal lipoma.