Ileocolic intussusception caused by giant submucosal colonic lipoma: A rare case report

INTRODUCTION: An adult intussusception is associated with a pathological lesion involving a lead point, such as a benign polyp, enlarged mesenteric lymph node, lipoma, Meckel's diverticulum, lymphoma, gastrointestinal stromal tumor, primary, or metastatic adenocarcinoma. A lipoma is usually asymptomatic, however, lipomas >2 cm may cause intussusception by forming a lead point. PRESENTATION OF CASE: A 46-year-old South Korean man was admitted and presented with a two-week history of intermittent abdominal pain and discomfort. Abdominal pelvic computed tomography scan revealed that about 6.5 cm of fat attenuation mass is present in the ascending colonic loop with about 15 cm of ileal loop pulled into the ascending colonic loop through the ileocecal valve. Mechanical obstruction with ileocolic intussusception was found in distal ileum. The colonoscopy detected a huge mass in the mid-ascending colon blocking the passage of the colonoscope. The patient was diagnosed with an ileocolic intussusception which was suspected to be a huge lipoma. Laparoscopic assisted right hemicolectomy was performed and the follow-up pathologic examination showed that it is a submucosal lipoma. CONCLUSION: The present case report concerns a 46-year-old male with a long segment ileocolic intussusception due to a giant lipoma arising from the ascending colon and whose intussusception was surgically resected.