Year: 2024
Type: article
Study design: Case Report
Abstract: Complete sigmoidorectal intussusception secondary to colonic lipomaA 64-year old female presented to the emergency department with sudden onset of severe, suprapubic abdominal pain.She complained of altered bowel habit for the last 12 months without history of rectal bleeding or weight loss.Her past medical history was significant for rhythm controlled atrial fibrillation without anticoagulation, osteoporosis and asthma.She had no prior abdominal surgery and was up to date with bowel cancer screening but had not had a prior colonoscopy.On examination, the patient was afebrile with normal vital signs.Abdominal examination demonstrated tenderness of the suprapubic region without local or generalized peritonism.Rectal examination demonstrated bright red blood and a palpable, soft mobile mass within the rectum which was not fixed to the rectal wall.Blood tests and urinalysis performed in the emergency department were unremarkable.Computerized tomography (CT) of the abdomen and pelvis revealed a complete intussusception of the sigmoid colon into the rectum associated with a 3.0 Â 2.9 Â 4.1 cm ovoid mass in the lower rectum (Fig. 1).The mass demonstrated fat attenuation without a definite soft tissue component consistent with a lipoma.The proximal colon and small intestine appeared dilated.The patient underwent an examination under anaesthesia at which time the submucosal lipoma was able to be partially delivered via the anus and was excised (Fig. 2).The intussusception was unable to be reduced with concurrent flexible sigmoidoscopy and laparoscopic manipulation of the oedematous and necrotic telescoped segment of bowel, so, via a pfannenstiel incision, the patient underwent segmental sigmoid resection with a primary double stapled colo-rectal anastomosis.Post-operative recovery was unremarkable and the patient was discharged on post-operative day 4. Histopathology demonstrated ischaemic colitis of the resected colon and confirmed the lead point to be a benign lipoma.
Source: ANZ Journal of Surgery
DOI: 10.1111/ans.19275
Institutions: Royal Prince Alfred Hospital, The University of Sydney
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4403493477