Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report

Jiro Shimazaki, Takeshi Nakachi, Takanobu Tabuchi, Shuji Suzuki, Hideyuki Ubukata, Takafumi Tabuchi

Adult intussusception is rare and usually caused by a tumor acting as the lead point. Therefore, laparotomy should be considered for the treatment. Laparoscopic procedures for use in cases of adult intussusception have been recently reported; however, there is no consensus regarding the safety and efficacy. Here, we describe a successful case of laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma, which was preoperatively suspected. An 87-year-old male presented with progressive abdominal distention and vomiting. Contrast radiography of the small intestine showed an ileal tumor, and magnetic resonance imaging indicated a target-like mass, consistent with an ileal intussusception. The patient was suspected with an intussusception due to an ileal lipoma, and laparoscopic surgery was performed. An approximately 10-cm-long ileal intussusception with a preceding tumor was present, and partial resection of the ileum, including the tumor, was performed. Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma. The patient had an uneventful recovery and was discharged on postoperative day 8. This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.