Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
Pan Afr Med J. 2020 Jul 21;36:200. doi: 10.11604/pamj.2020.36.200.24606. eCollection 2020.
Colo-rectal intussusception is rare in adults and is often secondary to malignant lesions, rarely benign lesions such as colonic lipomas can also be the cause. We present the case a 60-year-old man who presented to the emergency department with acute abdominal pain. On physical examination, the abdomen was distended with diffuse tenderness. CT scan of the abdomen revealed a colo-rectal intussusception secondary to a rectal lipoma with parietal pneumatosis of the invaginated loop. An emergency laparotomy was performed. Intraoperatively the radiological findings were confirmed. A rectosigmoid resection (Hartmann's procedure) taking off the lipoma and the invaginated segment of the colon was performed and the patient had an unevent full recovery. Histopathology confirmed a 6cm sub-mucosal lipoma without evidence of malignancy. As the diagnosis of a benign disease in patients presenting with colonic intussusception can only be made on pathological examination, this entity should be managed as a malignant lesion due to the high incidence of malignancy.
直肠-结肠肠套叠在成人中较为罕见，常继发于恶性病变，良性病变如结肠脂肪瘤也很少见，但也可能是病因。我们报告 1 例 60 岁男性，因急性腹痛就诊于急诊科。体格检查发现腹部膨隆，全腹压痛。腹部 CT 扫描显示直肠脂肪瘤继发的直肠-结肠肠套叠，套叠肠襻壁积气。行急诊剖腹探查术。术中证实了影像学发现。行直肠乙状结肠切除（Hartmann 手术），切除脂肪瘤和套叠的结肠段，患者恢复顺利。组织病理学证实为 6cm 黏膜下脂肪瘤，无恶性证据。由于仅通过病理检查才能诊断出患有结肠肠套叠的患者为良性疾病，因此鉴于恶性病变的高发生率，应将此类疾病视为恶性病变进行处理。
