Gastrointestinal Bleeding due to Intussuscepted Duodenal Lipoma: A Case Report

Duodenal lipomas are rare benign tumors which are typically asymptomatic but may cause significant gastrointestinal symptoms.

This case shows an uncommon presentation of duodenal intussusception due to a lipoma in a 65-year-old male patient, presenting with melena, hypotension, and vertigo. Upon investigation, a CT scan revealed a 5.7 × 7.1 cm lipomatous mass in the duodenum. Endoscopy confirmed the presence of associated bleeding. Despite initial management with proton pump inhibitors and blood transfusions, the patient required emergency endoscopic interventions for persistent bleeding. A subsequent laparotomy revealed an intussusception of the lipoma into the second part of the duodenum, thus also affecting the gastric antrum. The patient underwent distal gastrectomy and resection of the first part of the duodenum, followed by Roux-Y reconstruction. Histology showed that the submucosal lipoma originated from the first part of the duodenum.

This case highlights the rarity of duodenal lipoma as a cause of duodenal intussusception and emphasizes the diagnostic challenges associated with the identification of this condition in adults. Furthermore, it highlights the importance of an interdisciplinary team approach to manage this rare condition effectively.