Kansoun Alaa, Mohtar Iyad Al, Bahmad Marwan, Houcheimi Faisal, Maanieh Nisreen, Hazim Mouhamad, Rahal Khaled, Amiry Abdel Rahman, Hoteit Ali, Saeed Ahmad Abou, Fakhruddin Najla, Wehbe Mohammad
Lebanese University, Faculty of Medical Sciences, Department of General Surgery, Beirut, Lebanon.
Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
Int J Surg Case Rep. 2021 Apr;81:105695. doi: 10.1016/j.ijscr.2021.105695. Epub 2021 Mar 5.
Intestinal intussusception is rare in adults and it is associated with lead points affecting the colon in around 17% of patients. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Indeed, the incidence of intestinal intussusception is much rare when caused by lipomas.
Our patient is a 29-year-old male, previously healthy and admitted for severe right lower quadrant abdominal pain of 2-day duration. Computed tomography (CT) scan of the abdomen and pelvis showed large mass of fat consistency containing colon structure.
Urgent laparotomy was opted during which colo-colic intussusception was diagnosed and right hemicolectomy with primary ileocolic anastomosis was performed. Pathology report showed that intussusception was induced by a colon lipoma. Patient had an uneventful hospital stay and was discharged on post-operative day 5.
Thus we recommend that colo-colic intussusception caused by lipoma be considered in the differential when diagnosing adults with right lower quadrant pain.
成人肠套叠较为罕见，约17%的患者与影响结肠的引导点有关。脂肪瘤是非常罕见的良性肿瘤，可能成为肠套叠的引导点。事实上，由脂肪瘤引起的肠套叠发病率要低得多。
我们的患者是一名29岁男性，既往健康，因持续2天的严重右下腹疼痛入院。腹部和盆腔计算机断层扫描（CT）显示有一大块脂肪样肿物，内含结肠结构。
选择了急诊剖腹手术，术中诊断为结肠-结肠套叠，并进行了右半结肠切除术及一期回结肠吻合术。病理报告显示套叠由结肠脂肪瘤引起。患者住院过程顺利，术后第5天出院。
因此，我们建议在诊断右下腹疼痛的成人患者时，应将脂肪瘤引起的结肠-结肠套叠纳入鉴别诊断。
