# A rare presentation of adult colonic intussusception secondary to a descending colon lipoma: A case report

## TL;DR

A rare case of adult colonic intussusception caused by a benign lipoma is reported, highlighting the importance of imaging and surgery for diagnosis and treatment.

## Contribution

This case report adds to the limited literature on benign causes of adult colonic intussusception, specifically highlighting lipomas as a rare lead point.

## Key findings

- A 54-year-old woman presented with colonic intussusception caused by a 4.2 cm benign lipoma.
- CT imaging identified the fat-density mass as the lead point, guiding surgical intervention.
- Surgical resection confirmed the benign nature of the lesion and resolved the patient's symptoms.

## Abstract

Adult colonic intussusception is a rare and often diagnostically challenging condition, typically associated with a pathological lead point. While malignant tumors are more common causes in adults, benign lesions like colonic lipomas can also be responsible, albeit infrequently.

We report a case of a 54-year-old woman presenting with intermittent left lower abdominal pain and recent rectal bleeding. Contrast-enhanced abdominal CT demonstrated an incomplete descending colon intussusception with a fat-density mass as the lead point. She underwent a left hemicolectomy. Histopathology revealed a 4.2 × 4.3 cm pedunculated submucosal lipoma with no malignancy. Her postoperative course was uneventful, and she made a full recovery.

Adult intussusception often requires surgical intervention due to the high likelihood of underlying malignancy. Preoperative imaging, particularly CT, plays a crucial role in diagnosis and identifying the nature of the lead point. In this case, a benign lipoma caused the intussusception, but surgical resection was still warranted to exclude malignancy and relieve symptoms.

Though rare, colonic lipomas should be considered in adult intussusception cases. Cross-sectional imaging is essential for diagnosis, and surgical resection remains the mainstay of treatment. Early recognition and intervention can lead to excellent outcomes, as demonstrated in this case.

•Adult colonic intussusception is a rare clinical condition often caused by a malignant lead point.•Large colonic lipomas are uncommon but can act as benign lead points for intussusception.•CT imaging plays a central role in diagnosis, often revealing the characteristic “target sign” and fat-density mass.•Surgical resection without prior reduction remains the standard treatment to rule out malignancy and ensure complete removal.

Adult colonic intussusception is a rare clinical condition often caused by a malignant lead point.

Large colonic lipomas are uncommon but can act as benign lead points for intussusception.

CT imaging plays a central role in diagnosis, often revealing the characteristic “target sign” and fat-density mass.

Surgical resection without prior reduction remains the standard treatment to rule out malignancy and ensure complete removal.