Laparoscopic Management of Giant Submucosal Caecal Lipoma Presenting with Colocolic Intussusception: A Rare Case Report
S. N. Jatal *
Jatal Hospital and Research Centre, Latur, India.
Sudhir Jatal
Jatal Hospital and Research Centre, Latur, Tata Hospital, Mumbai, India.
Pratibha Sampte
Department of ENT, Government of Medical College, Latur, India.
Shubhangi Jatal
Department of Gynaecologist, MGM Hospital, Mumbai, India.
*Author to whom correspondence should be addressed.
Abstract
Intussusception occurs when a proximal segment of the gastrointestinal tract telescopes into the lumen of an adjacent distal segment. It is rare in adults, particularly when it involves the colon—referred to as colocolic intussusception. In adults, it is often associated with a pathological lead point, such as a tumour, and can result in bowel obstruction.
Clinical presentation in adults may include abdominal pain, vomiting, rectal bleeding, or other signs of intestinal obstruction. Although abdominal CT scanning can aid in diagnosis, many cases are only confirmed during surgery. Colocolic intussusception remains an uncommon cause of intestinal obstruction in the adult population. A case of a 23-year-old female diagnosed with colocolic intussusception due to a giant submucosal lipoma in the cecum was reported, which served as the lead point.
Diagnosis was made preoperatively using CT imaging. She underwent a laparoscopic right hemicolectomy with side-to-side ileocolic anastomosis and had an uneventful postoperative recovery. The most sensitive imaging modality for diagnosing intussusception, with sensitivity ranging from 71% to 87% and specificity approaching 100%.
Laparoscopic resection has become the gold standard for the removal of symptomatic colonic lipomas greater than 2–3 cm in diameter, offering the benefits of reduced postoperative pain, shorter hospital stays, and faster recovery compared to open surgery.
Keywords: Adult colocolic intussusceptions, giant submucosal lipoma, intestinal obstruction, laparoscopic hemicolectomy