Resolution of intussusception after spontaneous expulsion of an ileal lipoma per rectum: a case report and literature review

Abstract

We herein report a case of spontaneous rectal expulsion of an ileal lipoma in a 65-year-old female patient who presented with recurrent attacks of subacute intestinal obstruction. During each episode, the patient developed severe abdominal pain and expelled a fleshy mass from her rectum. The fleshy mass was histopathologically diagnosed as a lipoma comprising fat cells, fibers, and blood vessels. Upon expulsion, the pain disappeared and the intussusception was immediately resolved. Colonoscopic examination revealed a 2.5-cm diameter ulcerated lesion near the ileocecal valve, which was confirmed to be inflammation by pathological examination. A subsequent barium series revealed a normal colonic tract, and the patient remained completely symptom-free for 4 months after the incident. According to the relevant literature and our clinical experience, the treatment method for a lipoma depends on the patient’s clinical manifestations and the size of the tumor. However, the various diagnostic and therapeutic modalities currently available continue to be debated; whether an asymptomatic lipoma requires treatment is controversial. When histopathological examination results allow for the exclusion of malignant lesions such as sarcoma, a lipoma can be resected surgically.

A systematic review of symptomatic small bowel lipomas of the jejunum and ileum

“…Conservative management alone was effective in 4 patients. Spontaneous expulsion of a 7 × 4.5 × 3.6 cm ileal lipoma resolved a patient's intussusception and negated the need for surgical intervention as described by Kang [ 24 ]. Kim et al report a 50-year-old man who declined surgery after double balloon enteroscopy diagnosed multiple jejunal lipomatosis [ 25 ].…”

Partial spontaneous anal expulsion of the right colon lipoma: An exceptional diagnostic circumstance

“…In more than 75% of cases, these lesions are unique and attend the right colon, they are multiple in 10% of cases [4] . Under mucosal localisation is described in 90% of cases, it protrudes in the colonic lumen while under serous lipoma develops outside intestinal lumen [3] .…”

Unusual evolution of leiomyosarcoma of the rectum: a case report and review of the literature

“…In our case, the evolution was unusual compared to other reported cases, with spontaneous expulsion of the entire tumor through the rectum, it may be explained by the necrosis of the tumor pedicle. We did not find cases with such an evolution in the literature, but we found some cases of spontaneous expulsion of ileal lipoma per rectum [ 17 , 18 ]. As in our case, the mass was connected to the rectum by a pedicle.…”