Giant Pedunculated Colonic Lipoma Causing Colo-Colic Intussusception and a Rectal Bleeding

Intussusception is less common in adults than in children. Intussusception in adults is associated with an identifiable etiology in 90% of cases. Lipoma of the large intestine is rare; with a reported incidence ranging between 0.2% and 4.4%. Small Lipomas are usually asymptomatic, but giant Lipomas are often presented as abdominal pain, vomiting, diarrhea, bleeding and Intussusception. We present a case of 45-year-old man in our emergency room with intermittent abdominal cramps, rectal bleeding for eight days. Physical examination showed tenderness in the left lower abdominal quadrant. Blood found in rectal examination. Colonoscopy in two periods revealed an ulcerative mass in the proximal of descending colon. A CT scan showed a coil spring appearance highly suspicious for Intussusception of the descending-colon, a laparotomy was performed. The Intussusception was found in the descending colon, with extended left hemicolectomy, en-bloc resection was performed with end-to-end anastomosis. After surgical resection, the histo pathologic examination of the specimen showed the configuration of pedunculatedlipoma with tip ulceration, measuring 9x5x 6 cm in diameter. Patient discharged on day five post-operative with good condition.