Adult Intussusception Caused by Sigmoid Lipoma Leading to Colonic Obstruction

Adult Intussusception Caused by Sigmoid Lipoma Leading to Colonic Obstruction | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Adult Intussusception Caused by Sigmoid Lipoma Leading to Colonic Obstruction Nadine Abul-Khoudoud, Ravi Patel, Shane Quo, Steven Pack, Satish Patel This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8912498/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background: Adult intussusception is uncommon, accounting for approximately 1% of all cases of bowel obstruction. Unlike pediatric intussusception, which is often idiopathic, adult cases are typically associated with a pathological lead point. In colo-colonic intussusception, malignancy is the most frequent etiology, while benign causes such as colonic lipomas are rare, particularly when large enough to cause obstruction. Case Presentation: We report a case of a 68-year-old man who presented with two weeks of progressive hypogastric abdominal pain and constipation. Computed tomography of the abdomen and pelvis demonstrated distal transverse colon intussusception extending into the descending colon, with a large fat-containing mass consistent with a lipoma serving as the lead point. Flexible sigmoidoscopy revealed a necrotic, completely obstructing sigmoid mass, precluding endoscopic reduction. The patient underwent robotic segmental colectomy with primary anastomosis. Final pathology confirmed a 6.5 cm submucosal lipoma with mucosal ulceration and ischemic necrosis, without evidence of malignancy. The patient recovered uneventfully with complete resolution of symptoms. Conclusion: This case highlights a rare benign cause of adult colo-colonic intussusception. Although uncommon, giant colonic lipomas should be considered in the differential diagnosis when imaging reveals a well-circumscribed, fat-containing lesion. Early recognition and prompt surgical intervention are essential to prevent complications such as bowel ischemia and obstruction. Intussusception Colonic Obstruction Colonoscopy Case Report Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Intussusception is defined as the telescoping of a proximal segment of bowel into an adjacent distal segment, resulting in luminal obstruction and compromised blood flow [ 1 ]. While it is a common cause of intestinal obstruction in children, adult intussusception is rare and accounts for approximately 1% of bowel obstructions. Most adult cases occur in the small intestine or at the ileocecal junction, with colo-colonic intussusception comprising only about 17% of cases [ 2 ]. Unlike pediatric intussusception, which is idiopathic in the majority of cases, adult intussusception is usually associated with a structural lead point that does not spontaneously reduce [ 3 ]. In the colon, malignant lesions, most commonly adenocarcinoma and lymphoma, are responsible for the majority of cases [ 4 ]. Benign lead points, such as gastrointestinal lipomas, are uncommon and account for approximately 5% of all gastrointestinal tumors [ 1 ]. Due to the high likelihood of malignancy, surgical resection is generally recommended for adult colo-colonic intussusception [ 1 , 2 , 5 ]. We present a rare case of sigmoid colonic lipoma causing colo-colonic intussusception requiring surgical management. Case Report A 68-year-old Caucasian man with a medical history significant for type 2 diabetes mellitus managed with semaglutide, morbid obesity, hyperlipidemia, and hypertension presented with two weeks of progressively worsening hypogastric abdominal pain and constipation. He attributed his symptoms to a recent medication transition from liraglutide to semaglutide three months earlier. Initial outpatient management with laxatives provided temporary relief of constipation; however, abdominal pain, fullness, and nausea persisted. On presentation, vital signs were stable. Physical examination revealed abdominal distension and tenderness localized to the hypogastric region. Laboratory evaluation was unremarkable. Computed tomography of the abdomen and pelvis with intravenous contrast demonstrated intussusception of the distal transverse colon into the mid-descending colon, with a large, well-circumscribed fat-containing mass consistent with a lipoma serving as the lead point (Figs. 1 and 2). Additional findings included mild pericolonic fat stranding, hepatic steatosis, cholelithiasis, and chronic pancreatitis. A repeat CT scan with rectal contrast confirmed persistent intussusception, prompting urgent gastroenterology consultation. Flexible sigmoidoscopy revealed a large, necrotic, completely obstructing mass in the sigmoid colon approximately 30 cm from the anal verge, preventing further advancement of the scope and precluding decompression (Fig. 3). Endoscopic resection was not feasible, and biopsies were obtained to exclude malignancy. The patient subsequently underwent robotic segmental colectomy with primary anastomosis. Biopsy pathology demonstrated necrotic tissue with focal atypical vascular proliferation but no evidence of malignancy. Final surgical pathology confirmed a 6.5 cm submucosal lipoma with ulcerated overlying mucosa and adjacent ischemic necrosis, without carcinoma or adenoma. Postoperatively, the patient experienced complete resolution of symptoms and was discharged on postoperative day two in stable condition (Fig. 4). Discussion Intussusception is the leading cause of intestinal obstruction in children but accounts for only approximately 5% of adult intestinal obstructions [ 3 , 5 ]. In contrast to the 90% of pediatric cases that are idiopathic, 70 to 90% of adult intussusceptions are associated with an identifiable pathological lead point [ 3 , 5 ]. In the colon, nearly two-thirds of intussusceptions are caused by malignant neoplasms, most commonly adenocarcinoma and lymphoma [ 4 ]. Benign etiologies, including adenomas, endometriosis, postoperative anastomoses, Peutz–Jeghers polyps, and lipomas, comprise the remaining cases. Colonic lipomas are the third most common benign tumors of the colon, following hyperplastic and adenomatous polyps, and are most frequently located in the ascending colon [ 3 ]. Lipomas larger than 5 cm are classified as giant and are symptomatic in up to 75% of cases, often presenting with obstruction, bleeding, or intussusception [ 2 , 6 ]. Adult intussusception often presents with vague and nonspecific symptoms, such as: abdominal pain, nausea, vomiting, rectal bleeding, or altered bowel habits which frequently results in delayed diagnosis [ 1 , 5 ]. In this case, the patient’s symptoms were initially attributed to medication effects and managed conservatively, delaying definitive diagnosis until imaging was obtained. Abdominal CT is the diagnostic modality of choice for adult intussusception, with reported sensitivity of up to 87.5% and near-perfect specificity [1,3,]. Lipomas demonstrate characteristic low attenuation values (− 40 to − 120 Hounsfield units), aiding preoperative diagnosis. Colonoscopy allows for direct visualization and biopsy but may not permit reduction or resection in cases of complete obstruction or ischemia. Given the high risk of malignancy and potential for bowel compromise, surgical resection remains the definitive treatment for most adult colo-colonic intussusceptions [ 2 , 3 , 6 ]. Conclusion Adult colo-colonic intussusception due to a benign colonic lipoma is rare but clinically significant. This case emphasizes the need to consider benign etiologies in patients with nonspecific gastrointestinal symptoms and characteristic imaging findings. Prompt interdisciplinary evaluation and surgical management are essential to prevent complications such as bowel ischemia and perforation. Declarations Consent to Participate Informed consent was obtained from participants to participate in this study and for publication of this case report. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Data Availability : Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. Methods: This study was reviewed and approved through PubClear and the HCA Florida Bayonet Point Hospital Institutional Review Board (IRB). All methods were performed in accordance with the relevant guidelines and regulations, including the CARE (CAse REport) Guidelines (Consensus-based Clinical Case Reporting Guideline Development). Competing interests: The authors declare that they have no competing interests. Funding: There is no financial support or competing interests to report. Description of Authors Roles: N. Abul-Khoudoud and R. Patel contributed to the conception and interpretation of the work, drafting the work, and multiple reviews. S. Quo, S. Pack, S. Patel contributed to the design of the study and reviewed it critically for important intellectual content. All authors participated in the acquisition of data, reviewed the results and approved the final version of the manuscript. Acknowledgements: Not applicable. Clinical trial number : Not applicable References Amirhom E, Dondapati M, Horton N, Pescovitz AR. Large colonic lipoma as a lead point for intussusception in an adult. J Surg Case Rep. 2022 Jul 16;2022(7):rjac327. doi: 10.1093/jscr/rjac327. Erratum in: J Surg Case Rep . 2022 Nov 11;2022(11):rjac506. doi: 10.1093/jscr/rjac506. PMID: 35854819; PMCID: PMC9291366. M'rabet S, Jarrar MS, Akkari I, Abdelkader AB, Sriha B, Hamila F, Letaief R, Jazia EB. Colonic intussusception caused by a sigmoidal lipoma: A case report. Int J Surg Case Rep. 2018;50:1-4. doi: 10.1016/j.ijscr.2018.06.009. Epub 2018 Jun 23. PMID: 30059860; PMCID: PMC6079477. Waack A, Nandwani S, Kolisetty K, Vattipally V. Lipoma lead point intussusception in an adult: A case report. Radiol Case Rep . 2022 Oct 18;17(12):4907-4910. doi: 10.1016/j.radcr.2022.09.068. PMID: 36281283; PMCID: PMC9586856. Howard N, Pranesh N, Carter P. Colo-colonic intussusception secondary to a lipoma, International Journal of Surgery Case Reports , Volume 3, Issue 2, 2012, Pages 52-54, ISSN 2210-2612, https://doi.org/10.1016/j.ijscr.2011.10.011. Yakan S, Caliskan C, Makay O,Denecli A, Korkut M. Intussusception in adults: Clinical characteristics, diagnosis and operative strategies, World Journal of Gastroenterology. 2009 April 28; 15(16): 1985-1989. ISSN 1007-9327 doi:10.3748/wjg.15.1985 Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, Kuwano H. The diagnosis and treatment of adult intussusception. J Clin Gastroenterol . 2003 Jan;36(1):18-21. doi: 10.1097/00004836-200301000-00007. PMID: 12488701. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 13 Apr, 2026 Reviews received at journal 05 Apr, 2026 Reviews received at journal 03 Apr, 2026 Reviewers agreed at journal 15 Mar, 2026 Reviewers agreed at journal 13 Mar, 2026 Reviewers invited by journal 13 Mar, 2026 Editor invited by journal 13 Mar, 2026 Editor assigned by journal 03 Mar, 2026 Submission checks completed at journal 02 Mar, 2026 First submitted to journal 02 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8912498","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":606394567,"identity":"3f35febc-5b3e-47dc-858f-9d10c187521b","order_by":0,"name":"Nadine 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08:34:30","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":332429,"visible":true,"origin":"","legend":"\u003cp\u003eWhite arrow indicating the 6.5 cm sigmoid lipoma on CT, transverse view.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8912498/v1/6a102edd09c562e0052e36ac.png"},{"id":105562497,"identity":"18b34131-1f19-4730-94fe-ebd393a7e94e","added_by":"auto","created_at":"2026-03-27 12:41:38","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":969468,"visible":true,"origin":"","legend":"\u003cp\u003eDirect observation of the 6.5 cm sigmoid lipoma via endoscope during flexible sigmoidoscopy.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8912498/v1/f561f9604a334d29a7152a58.png"},{"id":105034117,"identity":"6dce9414-66b1-47ba-a395-6f821cf92c67","added_by":"auto","created_at":"2026-03-20 07:22:41","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":162210,"visible":true,"origin":"","legend":"\u003cp\u003eTimeline of patient events and hospital stay.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8912498/v1/f43e9d0beee34e0014707031.png"},{"id":105568722,"identity":"9a1544ba-49a5-4065-bc33-1ea72b986fe2","added_by":"auto","created_at":"2026-03-27 13:10:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2783277,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8912498/v1/df5f640e-0da5-45b6-8aeb-f01cec775535.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eAdult Intussusception Caused by Sigmoid Lipoma Leading to Colonic Obstruction\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIntussusception is defined as the telescoping of a proximal segment of bowel into an adjacent distal segment, resulting in luminal obstruction and compromised blood flow [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. While it is a common cause of intestinal obstruction in children, adult intussusception is rare and accounts for approximately 1% of bowel obstructions. Most adult cases occur in the small intestine or at the ileocecal junction, with colo-colonic intussusception comprising only about 17% of cases [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUnlike pediatric intussusception, which is idiopathic in the majority of cases, adult intussusception is usually associated with a structural lead point that does not spontaneously reduce [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In the colon, malignant lesions, most commonly adenocarcinoma and lymphoma, are responsible for the majority of cases [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Benign lead points, such as gastrointestinal lipomas, are uncommon and account for approximately 5% of all gastrointestinal tumors [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Due to the high likelihood of malignancy, surgical resection is generally recommended for adult colo-colonic intussusception [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. We present a rare case of sigmoid colonic lipoma causing colo-colonic intussusception requiring surgical management.\u003c/p\u003e"},{"header":"Case Report","content":"\u003cp\u003eA 68-year-old Caucasian man with a medical history significant for type 2 diabetes mellitus managed with semaglutide, morbid obesity, hyperlipidemia, and hypertension presented with two weeks of progressively worsening hypogastric abdominal pain and constipation. He attributed his symptoms to a recent medication transition from liraglutide to semaglutide three months earlier. Initial outpatient management with laxatives provided temporary relief of constipation; however, abdominal pain, fullness, and nausea persisted.\u003c/p\u003e \u003cp\u003eOn presentation, vital signs were stable. Physical examination revealed abdominal distension and tenderness localized to the hypogastric region. Laboratory evaluation was unremarkable. Computed tomography of the abdomen and pelvis with intravenous contrast demonstrated intussusception of the distal transverse colon into the mid-descending colon, with a large, well-circumscribed fat-containing mass consistent with a lipoma serving as the lead point (Figs.\u0026nbsp;1 and 2). Additional findings included mild pericolonic fat stranding, hepatic steatosis, cholelithiasis, and chronic pancreatitis.\u003c/p\u003e \u003cp\u003eA repeat CT scan with rectal contrast confirmed persistent intussusception, prompting urgent gastroenterology consultation. Flexible sigmoidoscopy revealed a large, necrotic, completely obstructing mass in the sigmoid colon approximately 30 cm from the anal verge, preventing further advancement of the scope and precluding decompression (Fig.\u0026nbsp;3). Endoscopic resection was not feasible, and biopsies were obtained to exclude malignancy.\u003c/p\u003e \u003cp\u003eThe patient subsequently underwent robotic segmental colectomy with primary anastomosis. Biopsy pathology demonstrated necrotic tissue with focal atypical vascular proliferation but no evidence of malignancy. Final surgical pathology confirmed a 6.5 cm submucosal lipoma with ulcerated overlying mucosa and adjacent ischemic necrosis, without carcinoma or adenoma. Postoperatively, the patient experienced complete resolution of symptoms and was discharged on postoperative day two in stable condition (Fig.\u0026nbsp;4).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIntussusception is the leading cause of intestinal obstruction in children but accounts for only approximately 5% of adult intestinal obstructions [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In contrast to the 90% of pediatric cases that are idiopathic, 70 to 90% of adult intussusceptions are associated with an identifiable pathological lead point [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In the colon, nearly two-thirds of intussusceptions are caused by malignant neoplasms, most commonly adenocarcinoma and lymphoma [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Benign etiologies, including adenomas, endometriosis, postoperative anastomoses, Peutz\u0026ndash;Jeghers polyps, and lipomas, comprise the remaining cases.\u003c/p\u003e \u003cp\u003eColonic lipomas are the third most common benign tumors of the colon, following hyperplastic and adenomatous polyps, and are most frequently located in the ascending colon [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Lipomas larger than 5 cm are classified as giant and are symptomatic in up to 75% of cases, often presenting with obstruction, bleeding, or intussusception [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdult intussusception often presents with vague and nonspecific symptoms, such as: abdominal pain, nausea, vomiting, rectal bleeding, or altered bowel habits which frequently results in delayed diagnosis [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In this case, the patient\u0026rsquo;s symptoms were initially attributed to medication effects and managed conservatively, delaying definitive diagnosis until imaging was obtained.\u003c/p\u003e \u003cp\u003eAbdominal CT is the diagnostic modality of choice for adult intussusception, with reported sensitivity of up to 87.5% and near-perfect specificity [1,3,]. Lipomas demonstrate characteristic low attenuation values (\u0026minus;\u0026thinsp;40 to \u0026minus;\u0026thinsp;120 Hounsfield units), aiding preoperative diagnosis. Colonoscopy allows for direct visualization and biopsy but may not permit reduction or resection in cases of complete obstruction or ischemia. Given the high risk of malignancy and potential for bowel compromise, surgical resection remains the definitive treatment for most adult colo-colonic intussusceptions [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAdult colo-colonic intussusception due to a benign colonic lipoma is rare but clinically significant. This case emphasizes the need to consider benign etiologies in patients with nonspecific gastrointestinal symptoms and characteristic imaging findings. Prompt interdisciplinary evaluation and surgical management are essential to prevent complications such as bowel ischemia and perforation.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cu\u003e\u003cstrong\u003eConsent to Participate\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from participants to participate in this study and for publication of this case report. A copy of the written consent is available for review by the Editor-in-Chief of this journal.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAvailability\u003c/strong\u003e: Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u0026nbsp;\u003c/strong\u003eThis study was reviewed and approved through PubClear and the HCA Florida Bayonet Point Hospital Institutional Review Board (IRB). All methods were performed in accordance with the relevant guidelines and regulations, including the CARE (CAse REport) Guidelines (Consensus-based Clinical Case Reporting Guideline Development).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e There is no financial support or competing interests to report.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDescription of Authors Roles:\u003c/strong\u003e N. Abul-Khoudoud and R. Patel contributed to the conception and interpretation of the work, drafting the work, and multiple reviews. S. Quo, S. Pack, S. Patel contributed to the design of the study and reviewed it critically for important intellectual content. All authors participated in the acquisition of data, reviewed the results and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e: Not applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAmirhom E, Dondapati M, Horton N, Pescovitz AR. Large colonic lipoma as a lead point for intussusception in an adult. \u003cem\u003eJ Surg Case Rep.\u003c/em\u003e 2022 Jul 16;2022(7):rjac327. doi: 10.1093/jscr/rjac327. Erratum in: \u003cem\u003eJ Surg Case Rep\u003c/em\u003e. 2022 Nov 11;2022(11):rjac506. doi: 10.1093/jscr/rjac506. PMID: 35854819; PMCID: PMC9291366.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eM\u0026apos;rabet S, Jarrar MS, Akkari I, Abdelkader AB, Sriha B, Hamila F, Letaief R, Jazia EB. Colonic intussusception caused by a sigmoidal lipoma: A case report. \u003cem\u003eInt J Surg Case Rep.\u003c/em\u003e 2018;50:1-4. doi: 10.1016/j.ijscr.2018.06.009. Epub 2018 Jun 23. PMID: 30059860; PMCID: PMC6079477.\u003c/li\u003e\n \u003cli\u003eWaack A, Nandwani S, Kolisetty K, Vattipally V. Lipoma lead point intussusception in an adult: A case report. \u003cem\u003eRadiol Case Rep\u003c/em\u003e. 2022 Oct 18;17(12):4907-4910. doi: 10.1016/j.radcr.2022.09.068. PMID: 36281283; PMCID: PMC9586856.\u003c/li\u003e\n \u003cli\u003eHoward N, Pranesh N, Carter P. Colo-colonic intussusception secondary to a lipoma, \u003cem\u003eInternational Journal of Surgery Case Reports\u003c/em\u003e, Volume 3, Issue 2, 2012, Pages 52-54, ISSN 2210-2612, https://doi.org/10.1016/j.ijscr.2011.10.011.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eYakan S, Caliskan C, Makay O,Denecli A, Korkut M. Intussusception in adults: Clinical characteristics, diagnosis and operative strategies, \u003cem\u003eWorld Journal of Gastroenterology.\u003c/em\u003e 2009 April 28; 15(16): 1985-1989. ISSN 1007-9327 doi:10.3748/wjg.15.1985\u003c/li\u003e\n \u003cli\u003eTakeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, Kuwano H. The diagnosis and treatment of adult intussusception. \u003cem\u003eJ Clin Gastroenterol\u003c/em\u003e. 2003 Jan;36(1):18-21. doi: 10.1097/00004836-200301000-00007. PMID: 12488701.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Medicine](https://link.springer.com/journal/44337)","snPcode":"44337","submissionUrl":"https://submission.springernature.com/new-submission/44337/3","title":"Discover Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Intussusception, Colonic Obstruction, Colonoscopy, Case Report ","lastPublishedDoi":"10.21203/rs.3.rs-8912498/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8912498/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eAdult intussusception is uncommon, accounting for approximately 1% of all cases of bowel obstruction. Unlike pediatric intussusception, which is often idiopathic, adult cases are typically associated with a pathological lead point. In colo-colonic intussusception, malignancy is the most frequent etiology, while benign causes such as colonic lipomas are rare, particularly when large enough to cause obstruction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Presentation:\u003c/strong\u003e We report a case of a 68-year-old man who presented with two weeks of progressive hypogastric abdominal pain and constipation. Computed tomography of the abdomen and pelvis demonstrated distal transverse colon intussusception extending into the descending colon, with a large fat-containing mass consistent with a lipoma serving as the lead point. Flexible sigmoidoscopy revealed a necrotic, completely obstructing sigmoid mass, precluding endoscopic reduction. The patient underwent robotic segmental colectomy with primary anastomosis. Final pathology confirmed a 6.5 cm submucosal lipoma with mucosal ulceration and ischemic necrosis, without evidence of malignancy. The patient recovered uneventfully with complete resolution of symptoms.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e This case highlights a rare benign cause of adult colo-colonic intussusception. Although uncommon, giant colonic lipomas should be considered in the differential diagnosis when imaging reveals a well-circumscribed, fat-containing lesion. Early recognition and prompt surgical intervention are essential to prevent complications such as bowel ischemia and obstruction.\u003c/p\u003e","manuscriptTitle":"Adult Intussusception Caused by Sigmoid Lipoma Leading to Colonic Obstruction","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-18 08:34:25","doi":"10.21203/rs.3.rs-8912498/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-13T11:38:10+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-05T14:29:56+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-03T13:21:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"121152867842018836040427337703297071766","date":"2026-03-15T16:06:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"273048903642860233948141362184505894028","date":"2026-03-13T13:52:16+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-13T09:55:14+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-13T06:53:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-03T05:41:36+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-03T03:00:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Medicine","date":"2026-03-03T01:16:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Medicine](https://link.springer.com/journal/44337)","snPcode":"44337","submissionUrl":"https://submission.springernature.com/new-submission/44337/3","title":"Discover Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2c3df739-7091-44d1-9168-945a92f3e6b5","owner":[],"postedDate":"March 18th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-28T08:23:17+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-18 08:34:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8912498","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8912498","identity":"rs-8912498","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}