Alsuhaimi Mohammed A, AlHewishel Mohmmed A, AlKhaldi May S, AlSumaihi Abdurahman S, AlDossri Hadi H, AlSaleh Eman F
General Surgery, Dammam Medical Complex, Dammam, SAU.
Pathology and Laboratory Medicine, Regional Lab, Dammam, SAU.
Cureus. 2025 Aug 9;17(8):e89696. doi: 10.7759/cureus.89696. eCollection 2025 Aug.
Adult intussusception is an uncommon cause of bowel obstruction, accounting for less than 5% of cases, and is often linked to a pathological lead point. Among benign etiologies, colonic lipomas are rare but recognized causes. We report a case of a 52-year-old male patient who presented with an atypically prolonged one-week history of intermittent abdominal pain and nausea, without signs of overt obstruction. Physical examination revealed abdominal tenderness and hypoactive bowel sounds. Contrast-enhanced computed tomography (CT) demonstrated a rare cecocolic intussusception with a fat-density mass in the transverse colon, suggestive of a colonic lipoma. Exploratory laparotomy confirmed a large submucosal lipoma acting as the lead point. Given the patient's age and the imaging ambiguity regarding malignancy, a limited right hemicolectomy was performed. Histopathology confirmed a benign submucosal lipoma. Postoperative recovery was uneventful, and the patient remained symptom-free at three-month follow-up. This case highlights an atypical, subacute presentation of adult intussusception caused by a colonic lipoma. It underscores the diagnostic utility of CT imaging and the rationale for an oncologically safe resection in uncertain cases, even with benign imaging features.
成人肠套叠是肠梗阻的罕见病因,占病例不到5%,且常与病理性引导点相关。在良性病因中,结肠脂肪瘤是罕见但已被认识的病因。我们报告一例52岁男性患者,其表现为非典型的、持续一周的间歇性腹痛和恶心病史,无明显梗阻迹象。体格检查发现腹部压痛和肠鸣音减弱。增强计算机断层扫描(CT)显示罕见的盲结肠套叠,横结肠有一个脂肪密度肿块,提示结肠脂肪瘤。剖腹探查证实一个大的黏膜下脂肪瘤为引导点。鉴于患者年龄以及关于恶性肿瘤的影像学不明确性,实施了有限的右半结肠切除术。组织病理学证实为良性黏膜下脂肪瘤。术后恢复顺利,患者在三个月随访时无症状。该病例突出了由结肠脂肪瘤引起的成人肠套叠的非典型、亚急性表现。它强调了CT成像的诊断效用以及在不确定病例中进行肿瘤学安全切除的理由,即使具有良性影像学特征。