Colocolic intussusception with intestinal obstruction in adults secondary to a colonic lipoma

We report the case of a woman in her early 60s, who presented with colocolic intussusception, leading to acute large bowel obstruction. The patient presented with colicky abdominal pain, diarrhoea mixed with blood and mucous and raised inflammatory markers. Abdominal examination revealed mild tenderness in the left lower abdomen. The CT scan reported colocolic intussusception extending from proximal to mid-sigmoid colon, with early ischaemic changes. The patient underwent laparoscopy-assisted sigmoid colectomy with an end colostomy and an uneventful postoperative recovery. Histopathological examination identified a benign colonic lipoma, with ischaemic and necrosed intussuscepted colonic segment. Intestinal intussusception is rare in adults and only accounts for 1% of the cases of intestinal obstruction in adults, mostly caused by a pathological lead point like colonic adenocarcinoma or a benign lipoma. Due to the potential risk of malignancy, radiological decompression is not advisable in adults, and en bloc resection of the intussuscepted segment is recommended.