Repeated Intussusception Induced by Intestinal Lipomatosis: Report of a Case

We describe a man with intestinal lipomatosis in association with repeated episodes of intussusception. A 50-year-old man came to our emergency department for intermittent epigastric cramping pain. Abdominal computed tomography scan revealed a doughnut sign and suspected ileo-colic intussusception. Emergent laparotomy showed ileo-colic intussusception involving the ileocecal valve, cecum and approximately 30cm of the ascending colon. Multiple submucosal tumors were noted to involve the whole small intestine and one tumor of the ileum formed the leading point of the intussusception. Right hemicolectomy with primary anastomosis was performed. Pathologic examination confirmed that the multiple lesions were benign submucosal lipomas. One month later, another episode of intussusception was noted. The affected intestinal segment was resected with ileo-ileostomy. In patients with intussusception caused by submucosal lipomatosis, surgery might be curative. If a large segment of bowel was affected by submucosal lipomatosis, resection of all lipomas might not be feasible. Smaller lipomas may be left in place because these tend to be asymptomatic. But they may become leading points of recurrent intussusception.