Adult intussusception is uncommon and usually presents with nonspecific symptoms. Cross-sectional imaging is extremely important for diagnosis. In adults, a lead point is often present and indicates the underlying cause, which can be benign or malignant. Therefore, the primary treatment is surgical resection. Colonic lipoma, although rare, is a frequent benign lesion that leads to colocolic intussusception. This report describes a 42-year-old woman who presented with 12 days of intermittent abdominal pain and no other associated symptoms. After multiple emergency department (ED) visits, her symptoms were initially attributed to constipation, as physical examination revealed only mild right lower quadrant tenderness, routine blood tests were within normal range, and abdominal X-ray (AXR) showed stool loading in the right colon. Subsequent cross-sectional imaging revealed a colocolic intussusception caused by a 5 cm submucosal lipoma acting as the lead point. She underwent open segmental colectomy with a primary side-to-side stapled anastomosis and was discharged on postoperative day eight without complications. Histopathology confirmed the presence of a lipoma and an incidental serrated adenoma. This case highlights the diagnostic challenge and the importance of cross-sectional imaging in patients presenting with nonspecific abdominal pain. Intussusception should be considered in the differential diagnosis of adults with abdominal pain. Computed tomography (CT) is essential for timely diagnosis, and surgical resection remains the mainstay of treatment, particularly in colocolic involvement.
Zubi et al. (Thu,) studied this question.
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