Ileoileal Intussusception in an Adult Due to Ileal Lipoma – A Rare Case Report

Case Report

Austin J Cancer Clin Res 2015;2(4): 1041.

Ileoileal Intussusception in an Adult Due to Ileal Lipoma – A Rare Case Report

Gupta P¹, Brown A¹, Musa O² and Srivastava AN¹*

¹Department of Pathology, Era’s Lucknow Medical College & Hospital, Lucknow, India

²Department of Surgery, Era’s Lucknow Medical College & Hospital, Lucknow, India

*Corresponding author: Srivastava AN, Department of Pathology, Era’s Lucknow Medical College & Hospital, Lucknow, India.

Received: April 24, 2015; Accepted: June 05, 2015; Published: July 29, 2015


Small Intestine tumors are rare, accounting for 1-2% of all gastrointestinal tract tumors. Among these, benign tumors are extremely rare with small intestinal lipomas being even more uncommon. They are usually asymptomatic, but may rarely cause intussusception and intestinal obstruction. We report a case of adult male presenting as sub-acute intestinal obstruction. Exploratory laprotomy revealed ileo-ileal intussusception secondary to lipoma which was successfully treated with segmental intestinal resection.

Intestinal intussusception in adults is rare and majority of the cases has an underlying cause with intraluminal lesions that requires surgical resection. A differential diagnosis of lipoma should always be kept in mind as a cause of intestinal intussusception, without a delay in proper treatment.

Keywords: Adult Intussusception; Small intestine; Lipoma; Intestinal obstruction; Ileoileal


Intussusception occurs when a proximal portion of the bowel called intussusceptum invaginates into the distal portion of the bowel called intussuscipiens [1-5]. Intussusception is a common condition in children, but rare in adults. Cause for paediatric intussusceptions is idiopathic in 90% of cases. Pneumatic or hydrostatic reduction of the intussusception is sufficient to treat the condition in 80% of the patients. Adult intussusception represents 5%-16% of all cases of intussusceptions and 1%-5% of all cases of intestinal obstruction [1-3,5-11]. Intussusceptions in adult have an organic lesion such as carcinoma, polyps, meckel’s diverticulum, colonic diverticulum, strictures or benign neoplasms in 70-90% of cases. Malignancy (adenocarcinoma) accounts for up to 30% of cases of intussusception occurring in the small intestine [12,13]. Due to significant risk of associated malignancy, radiological decompression is not recommended and definitive treatment, most often a surgical resection is needed, so a definitive diagnosis has to be made. Gastrointestinal lipomas are rare benign tumors and intussusceptions due to a gastrointestinal lipoma constitute an infrequent clinical entity. The majority of lipomas in the small bowel are solitary and approximately 5% are multiple [14]. Symptomatic lipoma manifestations are haemorrhage or intestinal obstruction. Here we report a case of small bowel lipoma in an adult male presenting with intestinal obstruction due to ileo-ileal intussusception.

Case Presentation

A 60-year-old male, presented with chief complaint of pain in abdomen since one week. The patient had no past history of peptic ulcer disease, alteration in bowel habits, melena or weight loss. On examination bowel loops were felt on abdominal palpation. Routine investigations were within normal limits. Ultrasonography showed dilated loops in lower abdomen showing feeble to absent peristalsis with minimum intra-bowel fluid suggestive of sub-acute intestinal obstruction.

On exploratory laparotomy ileo-ileal intussusception was present, 2 feet proximal to ileocaecal junction with polyp like growth in mucosal surface as a lead point of intussusception. Resection and ileo-ileal anastomosis was done. Grossly, the cut surface shows globular, pedunculated yellow and waxy growth measuring 3.5 X 2.3 cm. located 1 cm. from one resection end (Figure 1). Microscopically, section from growth showed sheets and lobules of adipocytes having eccentric nucleus & clear cytoplasm. Overlying ileal mucosa showing partially flattened villi lined by tall columnar cells and scattered goblet cells. (Figure 2) and other focal areas of intestine showed gangrenous changes. A histopathological diagnosis was reported as intussusception as a complication of S intestinal lipoma.

Citation: Gupta P, Brown A, Musa O and Srivastava AN. Ileoileal Intussusception in an Adult Due to Ileal Lipoma – A Rare Case Report. Austin J Cancer Clin Res 2015;2(4): 1041. ISSN 2381-909X