Jejunal lipoma with intermittent intussusception revealed by partial obstructive syndrome

Abstract

Jejunojejunal intussusceptions are not very common in adults, and unlike in children, a lead point is usually found. The clinical presentations in adults tend to be more chronic or intermittent, and they include obstructive syndrome, abdominal cramps, gastrointestinal bleeding, or palpable abdominal mass at physical examination. These unspecific symptoms often lead to late diagnosis after many investigations or even only after an inappropriately extensive surgery. We report the rare case of a 37-year-old female with intermittent bowel obstruction due to jejunojejunal intussusception secondary to the lipoma. The main clinical signs of this uncommon pathology are presented together with the necessary paraclinical investigations that enable surgical treatment.

Jejunojejunal intussusception secondary to submucosal lipoma resulting in a 5-year history of intermittent abdominal pain

“…They most commonly present with symptoms of intestinal obstruction or acute bleeding from mucosal ulceration 4. Obstructive symptoms are often non-specific, partial or episodic from intermittent intussusception and spontaneous reduction, resulting in delayed diagnosis and treatment 5. Of 51 reported cases of gastrointestinal lipomata causing adult intussusceptions, 26 were of small bowel origin and only 5 arose from the jejunum 3…”

A Rare Cause of Jejunojejunal Intussusception in an Adult

“…Adult intussusception is a rare disease and symptoms tend to be more chronic or intermittent with vague abdominal pain (71%), nausea and vomiting (68%), abdominal distension with partial obstruction (45%) or palpable mass at physical examination; therefore it is difficult to diagnose intussusception [2]. Ultrasonography is very appropriate and useful in the diagnosis of intussusception as it is more readily available and generalized technique than C.T, enabled to be used more often at the time of abdominal crisis.…”

“…C.T. scan with oral and intravenous contrast has been shown to be the most accurate diagnostic tool for the evaluation of intussusceptions [2].…”

“…The underlying causes in adults vary greatly, a mechanical cause is seen in 90% of all adult intussusceptions. The lead points of adult intussusceptions that involve colon are usually malignant; whereas those that involve the small bowel tend to be benign [2]. Preoperative diagnosis is often difficult because the symptoms are non specific.…”

Özefagustan rektuma gastrointestinal lipomların çok kesitli bilgisayarlı tomografi (MDBT) bulguları

“…Small-bowel lipomas tend to cause intussuseption but rarely cause intestinal intussusception (23). Intestinal lipomas arise from the mucinous layer.…”