Adult Colocolic Intussusception Secondary to Lipoma – Enterotomy over Resection–A Different Approach

Abstract

Intussusception occurs when a proximal segment of the gastrointestinal tract, called intussusceptum, telescopes into the lumen of an adjacent segment, also known as intussuscipiens. Intussusception is a serious and potentially life-threatening condition that requires immediate medical attention. In adults, it is often caused by a lead point, such as a tumor, polyp, or other abnormal growth in the gastrointestinal tract. Diagnosis of intussusception in adults is often challenging due to the lack of specific symptoms and because it is a rare condition in adults. In diagnosing this, a thorough history and clinical examination, as well as supplementary assistance with investigations, are all beneficial. A strong index of suspicion and a multidisciplinary approach are required for timely care. Current recommendations stipulate reduction and resection if necessary of small bowel adult intussusceptions, and resection without reduction of large bowel intussusceptions. We report herein one such case of adult colo-colic intussusception secondary to lipoma acting as the lead point, managed unconventionally with enterotomy and excision of lipoma, as opposed to conventional resection procedures. This case highlights the importance of considering unconventional surgical approaches in the management of rare cases like adult intussusception. Although resection procedures are the norm in such cases, an enterotomy and excision of the lead point can be a viable option, particularly in cases where the intussusception is confined to a small section of the bowel. Overall, this case contributes to the growing body of literature on the management of adult intussusception and emphasizes the need for careful consideration of surgical options based on the individual patient's presentation and circumstances.