Via Research Recognition Day Program VCOM-Carolinas 2025

Case Reports

The Case of the Dusky Colon and Submucosal Lipoma Holden Lewis OMS-III, Carolyn Dudko MD, Rachek Groening DO, Steven Matzinger MD PHD VCOM Carolinas, Spartanburg SC HCA Healthcare Grand Strand Medical Center, Myrtle Beach, SC

Introduction

Imaging

Discussion

- Intussusception is telescoping of the bowel - Ileocecal common in peds, 1/1300 in adults - Peds sx: currant jelly sputum - Adult sx: bilious vomiting, diffuse pain, hypoactive bowel sounds - Etiologies: anatomy, adhesions, masses - Lipomas usually on the trunk, neck or extremities

- Adult intussusception accounts for only 0.08% of all gastrointestinal surgeries - Mean demographic is 50-year-old males - While pediatric cases are treated with air enemas, adult cases require surgery due to risk of underlying malignancy - Identifying lead points should be paramount importance - Submucosal lipomas account for less than 4% of lead points - Lipomas in other parts of the colon can use endoscopy. Ileocolic is unable due to more complex anatomy and higher risk for complications

Case Presentation

- 69-year-old male with unremarkable past medical history presented with 6 months of diarrhea and crampy abdominal pain. Colonoscopy 1 year ago was normal, most recent showed ileal prolapse into cecum with dusky discoloration of colonic mucosa - Robotic assisted laparoscopic ileocecectomy and appendectomy were performed - Pathology revealed 3.5cm submucosal lipoma, serosal adhesions with a benign appendix - Admitted postoperatively for observation. The next day, the patient was ambulating, passing flatus without signs of obstruction - Patient was discharged the day after surgery with no complications

Figure 1. CT scan showing ileocolic intussusception

References

1. Roy J, Sall K, Megaris A, DiRoma F, Mukherjee I. Submucosal Lipoma Causing Small Bowel Intussusception. Cureus. 2021 Aug 22;13(8):e17367. doi: 10.7759/cureus.17367. PMID: 34567906; PMCID: PMC8454602. 2. Brill A, Lopez RA. Intussusception in Adults. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545264/ 3. Jain S, Haydel MJ. Child Intussusception. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from 4. Valdivielso Cortázar, Eduardo, et al. “Ileocolic Intussusception of Ileal Lipoma as a Cause of Lower Gastrointestinal Bleeding.” Gastroenterología y Hepatología (English Edition) , Elsevier, 1 Aug. 2017, www.elsevier.es/en-revista gastroenterologia-hepatologia-english-edition--382-articulo-ileocolic-intussusception-ileal-lipoma-as S2444382417301153.

Figure 2. Endoscopy showing ileocolic submucosal lipoma

2025 Research Recognition Day

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