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Laparoscopy-assisted resection of ileoileal intussusception caused by intestinal lipoma
Mong-Wei Lin1, Kuo-Hsin Chen, Heng-Fu Lin
1Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Insights
Adult intussusception is rare but often caused by tumors. This case highlights successful preoperative diagnosis via CT scans and minimally invasive laparoscopy-assisted surgery for ileoileal intussusception due to a lipoma.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Imaging
Background:
- Intussusception is a common pediatric abdominal emergency, but rare in adults, accounting for 1-3% of bowel obstructions.
- Unlike in children where it's often idiopathic, adult intussusception has a high incidence of underlying causes, frequently malignant lesions (around 50%).
- Preoperative diagnosis of adult intussusception is challenging due to vague clinical presentations.
Observation:
- A case of ileoileal intussusception in an adult patient is presented.
- The intussusception was caused by an intestinal lipoma, a benign tumor.
- Computed tomography (CT) scans enabled accurate preoperative diagnosis.
Findings:
- The patient underwent successful treatment via laparoscopy-assisted surgery.
- Laparoscopy-assisted surgery proved to be a feasible and effective therapeutic approach.
- The patient experienced an uneventful recovery and was discharged 4 days post-operation.
Implications:
- Highlights the importance of investigating adult intussusception for underlying pathologies, especially malignancy.
- Demonstrates the diagnostic utility of CT scans in identifying the cause of adult intussusception.
- Supports laparoscopy-assisted surgery as a viable and minimally invasive treatment option for adult intussusception, leading to faster recovery.
Abstract:
Intussusception is the second most common abdominal emergency in children. In contrast, it is rare in adults. Adult intussusception represents only 1%-3% of patients with bowel obstruction. Although 95% of intussusception in children is idiopathic, merely 7% of adult intussusception is considered idiopathic. Owing to vague symptoms and signs, the preoperative diagnosis of adult intussusception is difficult. Once adult intussusception is diagnosed, surgical intervention is indicated because about half of both colonic and small intestinal intussusceptions are caused by malignant lesions. In this paper, we describe a case of ileoileal intussusception caused by an intestinal lipoma that was diagnosed preoperatively by computed tomography scans and was treated successfully by laparoscopy-assisted surgery. The patient was discharged uneventfully 4 days after the operation. We recommend laparoscopy-assisted surgery as a feasible therapeutic option for adult intussusception.
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