Purpose: In contrast to childhood intussusception, adult intussusception is a rare disease and usually has a specific etiology. Malignancy is the leading cause, and gastrointestinal lipoma has been infrequently reported as a cause of adult
intussusception. However, GI lipoma can be easily diagnosed by current radiologic studies and can be managed less aggressively than intussusception with a malignant etiology. Methods: 5 adult (above 16 years old) patients have been identified to
be
operated on from January 1990 to June 1999 in Korea University Hospital due to intussusception caused by gastrointestinal lipoma. Their preoperative radiologic findings, operative methods and clinical results were analyzed, retrospectively.
Results:
There were 3 male and 2 female patients, and the mean age was 49. Simple abdominal X-rays were taken in all 5 patients, and mechanical obstructive patterns were present in 4 cases. Abdominal CT or ultrasonography was performed in 4 patients
preoperatively and demonstrated a lipoma in 3 cases (75%). In one patient, who showed toxic signs caused by mechanical intestinal obstruction, emergency exploration was undertaken without further preoperative radiologic study. The lipoma was
located at
the jejunum in 1 case, at the ileum in 2 cases and at the cecum in 2 cases. Resection of the involved segment of the bowel after reduction of intussusception was done in 3 cases and resection of involved bowel without reduction was done in the
remaining
2 cases. Consequently, segmental resection of the small bowel was performed in 2 cases and a right colectomy in 3 cases. There was no postoperative morbidity or mortality. Conclusion: Adult intussusception caused by a gastrointestinal lipoma can
be
easily diagnosed by using CT or ultrasonography. It can be safely managed through reduction and resection of the lesion unless there is strangulation.
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