A case of Ascending colon lipoma with intussusception

Abstract

The occurrence of intussusception in adults is rare, with an incidence of only 5-10%, but it occurs frequently in infants, especially in the first two years of life.
We report a case of ascending colon lipoma with intussusception in a 65-year-old man who complained of right upper quadrant pain and abdominal bloating that persisted for several weeks. Abdominal CT showed a smooth mass of fat density in the transverse colon as the lead point of intussusception. Colonoscopy showed that the mass had almost obstructed the whole lumen in the transverse colon. The mass had erosions and redness on the surface, and it was hard and the cushion sign was negative. Colonoscopy showed features different from those of typical lipoma, making diagnosis before the operation difficult. However, abdominal CT indicated that the mass was lipoma. The patient underwent surgical resection. Histological examination revealed a large pedunculated mass measuring 5 × 5.5cm that consisted of mature adipose tissue, and the tumor was diagnosed as a submucosal lipoma.
In cases of a large digestive lipoma complicated with intussusception, the lipoma can be inflamed because of circulatory disturbance on the surface and the appearance may not be like lipoma. Care is therefore needed in diagnosis in such cases.