A Rare Case of Colo-Colonic Intussusception Caused by Colonic Submucosal Lipoma

Area of Science:

• Gastroenterology
• Radiology
• Surgical Oncology

Background:

• Intussusception is a common pediatric emergency but presents differently in adults, often with subtle, prolonged symptoms.
• Colo-colonic intussusception is rare in adults (<20%) and frequently associated with mass-like lesions, potentially indicating malignancy.
• Delayed diagnosis of adult intussusception increases morbidity, mortality, and healthcare costs.

Observation:

• A 42-year-old female presented with a two-month history of intermittent abdominal pain.
• Initial imaging failed to detect colo-colonic intussusception.
• Abdominal CT scan confirmed colo-colonic intussusception, initially missed.

Findings:

• Adult intussusception diagnosis can be difficult due to non-specific symptoms.
• CT scans, particularly when combined with ultrasound, achieve high accuracy (95.5%) in pre-operative diagnosis of adult intussusception.
• Over 50% of adult intussusceptions are linked to underlying mass lesions, necessitating investigation for malignancy.

Implications:

• Intussusception should be considered in the differential diagnosis for adult abdominal pain, even with sub-acute presentations.
• Prompt diagnosis via imaging like CT is vital to reduce patient morbidity and healthcare expenditure.
• Colonoscopy and considering non-surgical management are important aspects of adult intussusception care.