03May 2019

ILEOCOLIC INTUSSUSCEPTION CAUSED BY A LIPOMA IN AN ADULT.

  • Resident, Department of Medical gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
  • Head of the department, Department of Medical gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
  • Head of the department, Department of Surgical gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Crossref Cited-by Linking logo
  • Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Intussusception rarely observed in adults accounts for only 5% of all the cases and almost 1%-5% of bowel obstruction cases. The aetiology, presentation and management in adults are different from those in children. The clinical presentation in adults often includes nonspecific signs and symptoms, thereby complicating differential diagnosis from other causes of abdominal pain. We report a case of 47year-old Asian man who presented to the OPD with complaints of recurrent crampy type of lower abdominal pain for the past 4 years. Colonoscopy showed ileocolonic intussusception with overlying mass extending up to splenic flexure with spontaneous regression. Abdominal CT demonstrated ileocolic intussusception, and hence segmental ileo-colonic resection was done and ileo-ascending colon was anastomosed. Histopathology report of the resected specimen confirmed asub mucosal lipoma measuring 4.5 cm with extensive fat necrosis. Proper vigilance and appropriate investigations help in prompt diagnosis and surgical referral help enable favourable outcomes.

  1. Ghaderi H, Jafarian A, Aminian A, MirjafariDaryasari SA. Clinical presentations, diagnosis and treatment of adult intussusception, a 20 years survey. Int J Surg2010; 8: 318?320 [PMID: 20359557 DOI: 10.1016/j.ijsu.2010.02.013]
  2. Haas EM, Etter EL, Ellis S, Taylor TV. Adult intussusception. Am J Surg2003; 186: 75?76 [PMID: 12842754]
  3. Barussaud M, Regenet N, Briennon X, de Kerviler B, Pessaux P, Kohneh?Sharhi N, Lehur PA, Hamy A, Leborgne J, le Neel JC, Mirallie E. Clinical spectrum and surgical approach of adult intussusceptions: a multicentric study. Int J Colorectal Dis 2006; 21: 834?839 [PMID: 15951987 DOI: 10.1007/s00384?005?0789?3]
  4. Marinis A, Yiallourou A, Samanides L, Dafnios N, Anastasopoulos G, Vassiliou I, Theodosopoulos T. Intussusception of the bowel in adults: a review. World J Gastroenterol2009; 15: 407?411 [PMID: 19152443 DOI: 10.3748/wjg.15.407]
  5. Stringer MD, Pablot SM, Brereton RJ. Paediatric intussusception. Br J Surg1992; 79: 867?876 [PMID: 1422744]
  6. Shapkina AN, Shapkin VV, Nelubov IV, Pryanishena LT. Intus? susception in children: 11?year experience in Vladivostok. PediatrSurgInt2006; 22: 901?904 [PMID: 17021742 DOI: 10.1007/s00383? 006?1764?y]
  7. Parashar UD, Holman RC, Cummings KC, Staggs NW, Curns AT, Zimmerman CM, Kaufman SF, Lewis JE, Vugia DJ, Powell KE, Glass RI. Trends in intussusception?associated hospitalizations and deaths among US infants. Pediatrics 2000; 106: 1413?1421 [PMID: 11099597]
  8. Rogers SO, Lee MC, Ashley SW. Giant colonic lipoma as lead point for intermittent colo?colonic intussusception. Surgery 2002; 131: 687?688 [PMID: 12075187]
  9. Azar T, Berger DL. Adult intussusception. Ann Surg1997; 226: 134?138 [PMID: 9296505]
  10. Begos DG, Sandor A, Modlin IM. The diagnosis and management of adult intussusception. Am J Surg1997; 173: 88?94 [PMID: 9074370 DOI: 10.1016/S0002?9610(96)00419?9]
  11. Eisen LK, Cunningham JD, Aufses AH. Intussusception in adults: institutional review. J Am CollSurg1999; 188: 390?395 [PMID: 10195723]
  12. Weilbaecher D, Bolin JA, Hearn D, Ogden W. Intussusception in adults. Review of 160 cases. Am J Surg19
  13. Yakan S, Caliskan C, Makay O, Denecli AG, Korkut MA. Intussusception in adults: clinical characteristics, diagnosis and operative strategies. World J Gastroenterol2009; 15: 1985?1989 [PMID: 19399931 DOI: 10.3748/wjg.15.1985]
  14. Chang CC, Chen YY, Chen YF, Lin CN, Yen HH, Lou HY. Adult intussusception in Asians: clinical presentations, diagnosis, and treatment. J GastroenterolHepatol2007; 22: 1767?1771 [PMID: 17914948 DOI: 10.1111/j.1440?1746.2007.04907.x]
  15. Smith DS, Bonadio WA, Losek JD, Walsh?Kelly CM, Hennes HM, Glaeser PW, Melzer?Lange M, Rimm AA. The role of abdominal x?rays in the diagnosis and management of intussusception. PediatrEmerg Care 1992; 8: 325?327 [PMID: 1454638]
  16. Reijnen HA, Joosten HJ, de Boer HH. Diagnosis and treatment of adult intussusception. Am J Surg1989; 158: 25?28 [PMID: 2662787]
  17. Yu JP, Luo HS, Wang XZ. Endoscopic treatment of submucosal lesions of the gastrointestinal tract. Endoscopy 1992; 24: 190?193 [PMID: 1587236 DOI: 10.1055/s?2007?1010460].

[Siddhartha Reddy A, Ganesh P and Sankar S. (2019); ILEOCOLIC INTUSSUSCEPTION CAUSED BY A LIPOMA IN AN ADULT. Int. J. of Adv. Res. 7 (May). 143-146] (ISSN 2320-5407). www.journalijar.com

Dr. Siddhartha Reddy A
Sri Ramachandra Institute of Higher Education and Research, Chennai, India

DOI:

Article DOI: 10.21474/IJAR01/9013      
DOI URL: http://dx.doi.org/10.21474/IJAR01/9013

Download Full Paper

Download PDF No. of Downloads: 13 | No. of Views: 67