Abstract
Colonic lipomas are usually asymptomatic and only occasionally cause colonic intussusception in adults. We report a case of adult intussusception caused by a sigmoidal lipoma in which transanal resection of the lipoma with a linear stapler enabled laparoscopic reduction of the intussusception.
A 24-year-old female visited our emergency unit complaining of lower abdominal pain. Abdominal CT revealed colonic intussusception caused by a sigmoidal lipoma measuring 4 cm in diameter. The segment involved was long and the lipoma had descended down to the upper rectum. The intussusception was irreducible by contrast enema using a water-soluble contrast agent or colonoscopy, and laparoscopic colectomy was planned.
Subsequently, transanal examination under general anesthesia revealed that the lipoma had descended further down into the lower rectum. The lipoma was then successfully removed transanally with a linear stapler and the intussusception was reduced under laparoscopic and colonoscopic assistance. The postoperative course was uneventful.
In adult colonic intussusception, transanal resection of the culprit lesion with a linear stapler may help avoid unnecessary colonic resection.
