Submucosal lipoma with colonic intussusception
7 day history of constipation and abdominal pain
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CT images showed dilated small and large loops of bowel with multiple air-fluid levels. A transition point is seen in the left hypochondrium where the transverse colon invaginates into the splenic flexure, giving the bowel-in-bowel appearance. Onion peel appearance is demonstrated on the coronal images. There is a fat attenuation lesion as the lead point, most consistent with a submucosal intestinal lipoma.
Colonic lipomas are rare causes of large bowel intussusception. In adult patients, the commonest cause of intussusception is malignancy, usually primary colon cancers.
- Kim YH, Blake MA, Harisinghani MG, Archer-Arroyo K, Hahn PF, Pitman MB, Mueller PR. Adult intestinal intussusception: CT appearances and identification of a causative lead point. (2006) Radiographics : a review publication of the Radiological Society of North America, Inc. 26 (3): 733-44. doi:10.1148/rg.263055100 - Pubmed