Adult Sigmoid Colo-colic Intussesception Due to Polypoidal Lipoma: A Rare Case Report

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.