Publication:

Colonic intussusception caused by a giant colonic lipoma: case report and literature review

Colonic lipomas are rare benign tumours that frequently remain asymptomatic. However, when large in size, they may cause serious complications such as intussusception and bowel obstruction, challenging differentiation from malignant neoplasms. This paper reports the case of a 54-year-old male patient admitted to the emergency department with intermittent abdominal pain and progressive constipation over two months. Computed tomography revealed colo-colonic intussusception involving the descending and sigmoid colon with a 4.2 cm endoluminal lesion suggestive of neoplasia. Colonoscopy confirmed a pedunculated stenotic mass, enabling intussusception reduction, but diagnostic biopsy was not feasible. Due to persistent obstructive symptoms, inability to exclude malignancy, and risk of recurrent intussusception, left colectomy via laparotomy was performed. Pathological examination confirmed a benign submucosal lipoma measuring 4.2×3.5×3.5 cm without signs of malignancy. Postoperative course was uneventful with progressive bowel recovery and hospital discharge in good clinical condition. This report emphasizes the importance of accurate differential diagnosis of colonic lipomas, judicious indication for surgical resection in complicated giant lipomas, and minimally invasive techniques available for management of this condition.