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Case Reports in Surgery
Volume 2016, Article ID 3519606, 4 pages
http://dx.doi.org/10.1155/2016/3519606
Case Report

Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma

1Azienda Socio-Sanitaria di Vimercate, Presidio di Carate, Via Mosè Bianchi 9, 20841 Carate Brianza, Italy
2Azienda Socio-Sanitaria di Vimercate, Presidio di Vimercate, Via Santi Cosma e Damiano 10, 20871 Vimercate, Italy
3Azienda Ospedaliera di Desio e Vimercate, Presidio di Carate, Via Mosè Bianchi 9, 20841 Carate Brianza, Italy

Received 26 July 2016; Accepted 14 November 2016

Academic Editor: Paola De Nardi

Copyright © 2016 Tiziana Casiraghi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions). Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation. A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm) was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion. Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%); since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.