A rare presentation of adult colonic intussusception secondary to a descending colon lipoma: A case report.

Introduction and importance: Adult colonic intussusception is a rare and often diagnostically challenging condition, typically associated with a pathological lead point. While malignant tumors are more common causes in adults, benign lesions like colonic lipomas can also be responsible, albeit infrequently. Case presentation: We report a case of a 54-year-old woman presenting with intermittent left lower abdominal pain and recent rectal bleeding. Contrast-enhanced abdominal CT demonstrated an incomplete descending colon intussusception with a fat-density mass as the lead point. She underwent a left hemicolectomy. Histopathology revealed a 4.2 × 4.3 cm pedunculated submucosal lipoma with no malignancy. Her postoperative course was uneventful, and she made a full recovery. Clinical discussion: Adult intussusception often requires surgical intervention due to the high likelihood of underlying malignancy. Preoperative imaging, particularly CT, plays a crucial role in diagnosis and identifying the nature of the lead point. In this case, a benign lipoma caused the intussusception, but surgical resection was still warranted to exclude malignancy and relieve symptoms. Conclusion: Though rare, colonic lipomas should be considered in adult intussusception cases. Cross-sectional imaging is essential for diagnosis, and surgical resection remains the mainstay of treatment. Early recognition and intervention can lead to excellent outcomes, as demonstrated in this case.