AB198. SOH26AB_0072. Lipoma as a cause of intussusception and small bowel obstruction in adult: a case report

Background: Intussusception is the telescoping of a proximal segment of the gastrointestinal tract into an adjacent distal segment. It accounts for 1% to 5% of adult intestinal obstruction. Lipoma in the small bowel is rare, with an incidence between 0.15% and 4.4%.

Case Description: A 36-year-old male with no previous medical or surgical history presented with a gradual onset, colicky, periumbilical, and epigastric pain for 3 days associated with vomiting and diarrhoea. On examination, his abdomen was soft and mildly distended. His plain film abdomen (PFA) shows dilated small bowel loops with paucity of other bowel gas. Computed tomography (CT) abdomen and pelvis (AP) shows a 6 cm intraluminal small bowel lesion resulting in a segment of small bowel intussusception and bowel obstruction. Emergency laparotomy was performed, and this showed an intussuscepted small bowel segment. This was resected without any reduction attempts, and a side-to-side small bowel anastomosis was performed. The patient was admitted to the intensive care unit for 1 day postoperatively. His postoperative course was uncomplicated. His diet was escalated in a stepwise manner, and he was discharged home well on postoperative day 7. Histopathology of the resected segment revealed it to be a benign lipoma.

Conclusions: Intussusception is rare in adults, and intussusception secondary to a lipoma as a lead point is even rarer. Thus, early diagnosis with a CT scan and definitive surgical management is imperative to ensure a good clinical outcome.

Keywords: Adult intussuception; case report; lipoma; obstruction; lead point