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Giant submucosal lipoma cause colo-colonic intussusception. A case report and review of literature.
Ann Ital Chir. 2012 Nov-Dec; 83(6):559-62.AI

Abstract

BACKGROUND

Lipoma of the large intestine is rare, with a reported incidence ranging between 0.2% and 4.4%. We present a case of a giant colonic lipoma causing descending-colonic intussusception.

AIMS

A 54-year-old woman visited our emergency room with sudden onset of intermittent abdominal cramps. She was nauseous and had rectal blood loss for three days. Physical examination showed a tender palpable mass in the left lower abdominal quadrant. Rectal examination showed little blood on the glove. A CT scan demonstrated a clear intussusception of the descending-colonic (Fig. 1). Since the clinical presentation was that of an imminent ileus a laparotomy was performed. The intussusception was found in the descending coloni (Fig. 2), en-bloc resection with left hemicolectomy and was performed with end-to-end anastomosis.

DISCUSSION

Lipomas of the gastrointestinal tract are rare conditions first described by Baurer in 1757. Lipomas in the intestinal tract are still relatively rare, however, being present in only 0.2% of a large autopsy series of 60 000 cases reported in 1955. In 90% of cases, lipoma of the colon are localized at submucous level. Submucosal lipomas are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. Accurate preoperative diagnosis is difficult and lipoma is often mistaken for adenomatous polyp or carcinoma.

CONCLUSION

Differential diagnosis includes malignancy, diverticulosis, adenomatous polyps and previous anastomosis. CT is the examination of choice. Surgical approach remains the treatment of choice for large colon lipoma.

Authors+Show Affiliations

Department of General Surgery and Traumatology, Locarno Reginal Hospital , Switzerland. emanue14@alice.itNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

23110909

Citation

Grasso, Emanuele, and Tommaso Guastella. "Giant Submucosal Lipoma Cause Colo-colonic Intussusception. a Case Report and Review of Literature." Annali Italiani Di Chirurgia, vol. 83, no. 6, 2012, pp. 559-62.
Grasso E, Guastella T. Giant submucosal lipoma cause colo-colonic intussusception. A case report and review of literature. Ann Ital Chir. 2012;83(6):559-62.
Grasso, E., & Guastella, T. (2012). Giant submucosal lipoma cause colo-colonic intussusception. A case report and review of literature. Annali Italiani Di Chirurgia, 83(6), 559-62.
Grasso E, Guastella T. Giant Submucosal Lipoma Cause Colo-colonic Intussusception. a Case Report and Review of Literature. Ann Ital Chir. 2012 Nov-Dec;83(6):559-62. PubMed PMID: 23110909.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Giant submucosal lipoma cause colo-colonic intussusception. A case report and review of literature. AU - Grasso,Emanuele, AU - Guastella,Tommaso, PY - 2012/11/1/entrez PY - 2012/11/1/pubmed PY - 2013/1/8/medline SP - 559 EP - 62 JF - Annali italiani di chirurgia JO - Ann Ital Chir VL - 83 IS - 6 N2 - BACKGROUND: Lipoma of the large intestine is rare, with a reported incidence ranging between 0.2% and 4.4%. We present a case of a giant colonic lipoma causing descending-colonic intussusception. AIMS: A 54-year-old woman visited our emergency room with sudden onset of intermittent abdominal cramps. She was nauseous and had rectal blood loss for three days. Physical examination showed a tender palpable mass in the left lower abdominal quadrant. Rectal examination showed little blood on the glove. A CT scan demonstrated a clear intussusception of the descending-colonic (Fig. 1). Since the clinical presentation was that of an imminent ileus a laparotomy was performed. The intussusception was found in the descending coloni (Fig. 2), en-bloc resection with left hemicolectomy and was performed with end-to-end anastomosis. DISCUSSION: Lipomas of the gastrointestinal tract are rare conditions first described by Baurer in 1757. Lipomas in the intestinal tract are still relatively rare, however, being present in only 0.2% of a large autopsy series of 60 000 cases reported in 1955. In 90% of cases, lipoma of the colon are localized at submucous level. Submucosal lipomas are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. Accurate preoperative diagnosis is difficult and lipoma is often mistaken for adenomatous polyp or carcinoma. CONCLUSION: Differential diagnosis includes malignancy, diverticulosis, adenomatous polyps and previous anastomosis. CT is the examination of choice. Surgical approach remains the treatment of choice for large colon lipoma. SN - 0003-469X UR - https://www.unboundmedicine.com/medline/citation/23110909/Giant_submucosal_lipoma_cause_colo_colonic_intussusception__A_case_report_and_review_of_literature_ L2 - https://medlineplus.gov/colonicdiseases.html DB - PRIME DP - Unbound Medicine ER -