# Colocolic intussusception due to lipoma in an adolescent with refractory anal fissure; case report and literature review

## TL;DR

A 13-year-old boy with chronic constipation and anal fissure was found to have an unexpected colocolic intussusception caused by a lipoma, highlighting the need for vigilance in diagnosing this condition in adolescents.

## Contribution

This case report highlights the rare occurrence of intussusception in adolescents due to lipoma and emphasizes the importance of considering it in atypical presentations.

## Key findings

- Colocolic intussusception was incidentally discovered via MRI in a 13-year-old with refractory anal fissure and constipation.
- Lipomas can cause intussusception even in adolescents, despite being generally asymptomatic.
- Nonspecific symptoms like abdominal pain and constipation can mask the presence of intussusception in older patients.

## Abstract

Intussusception is uncommon in older patients, making its diagnosis challenging and necessitating a high level of clinical suspicion. While pediatric intussusception typically presents with a triad of symptoms including abdominal pain, bloody diarrhea, and an abdominal mass, the majority of adult patients experience chronic abdominal pain and partial obstruction. Consequently, the diagnosis of adult intussusception may be delayed due to the similarity in presentation with other conditions.

In this article, we have presented a 13-year-old boy with chronic and refractory anal fissure. The patients also complained of constipation for a year, intermittent abdominal pain, and bloating. Although he was treated with conservative laxative medications, the constipation was not relieved. Incidentally, a colocolic intussusception was found through an MRI.

We have provided a comprehensive description of an unexpected intussusception at an uncommon age which was found incidental. Medical literature was reviewed for better optimal planning in surgery.

Intussusception in a teenager is unexpected, and this case shows the importance of considering it even in the presence of nonspecific symptoms. This case serves as a reminder to healthcare professionals to consider intussusception as a potential diagnosis in similar cases.

•Consequently, the diagnosis of adult intussusception may be delayed due to the similarity in presentation with other conditions.•Lipomas, generally asymptomatic, but they can occasionally lead to complications such as intussusception.•Intussusception in an adolescent is less expected, and this case shows the importance of considering it even in the presence of nonspecific symptoms.•This case serves as a reminder to healthcare professionals to consider intussusception as a potential diagnosis in similar cases.

Consequently, the diagnosis of adult intussusception may be delayed due to the similarity in presentation with other conditions.

Lipomas, generally asymptomatic, but they can occasionally lead to complications such as intussusception.

Intussusception in an adolescent is less expected, and this case shows the importance of considering it even in the presence of nonspecific symptoms.

This case serves as a reminder to healthcare professionals to consider intussusception as a potential diagnosis in similar cases.