There was no evidence of dysplasia or malignancy. Figure 1 Abdominal X-Ray. In favor of bowel obstruction. Figure 2 Abdominal computed tomography . Showing a fatty oval mass in the small intestine. Figure 3 Computed tomography scan of

the abdomen without oral contrast . A longitudinal cut view of the intussusception shows the “sausage” shape. Figure 4 Intraoperative findings of the lipoma: A pedunculated lesion, measuring 60 mm, was the lead see more point of the intussusception. Figure 5 Histological findings of the tumor . A histopathologic examination of the tumor revealed fat cells proliferating in the submucosal layer. Discussion Intussusceptions in adulthood is unusual, with an incidence of approximately 2-3 cases per population of 1 000 000 per year [5]. The most common classification system divides intussusceptions into four categories: enteric, ileocolic, ileocaecal and colonic [1–4]. In adults, intussusceptions is more likely to present insidiously with vague abdominal symptoms and rarely presents with the classic triad of vomiting, abdominal pain and passage of blood per rectum, making diagnosis difficult [6]. Tumors of the small bowel account for only 1% to 2% of all gastrointestinal tumors, and benign tumors account for approximately 30% of all small-bowel tumors

[7]. Lipomas are benign tumors of mesenchymal origin. They are the second most common benign tumors in the small intestine and account for 10% of all benign gastrointestinal tumors and 5% of all gastrointestinal tumors [1, 2, 5]. Gastrointestinal lipomas are most commonly located in the colon (65% to 75%), small bowel (20% to 25%) and Epigenetics inhibitor occasionally in the foregut (< 5%) [8]. Fifty-one cases of adult intussusceptions induced by a lipoma, including our present case, have been reported in the English literature during the past decade (Table  1) [9]. Lipomas are largely asymptomatic. The majority of presenting features (-)-p-Bromotetramisole Oxalate are either

intestinal obstruction or hemorrhage [1, 2, 5–8]. Their usual location in the small intestine is ileum (50%) while jejunum is the least common. The peak age of incidence is in the 6th-7th decades of life and it appears that females are more prone to lipomas. Malignant degeneration has never been reported [5]. The clinical presentation is very non-specific which makes this a difficult condition to diagnose. According to the literature, only 32% to 50% of cases are diagnosed preoperatively, despite the evolution of imaging methods [9–11]. Abdominal pain, nausea, Selleckchem CX-6258 diarrhea and bleeding per rectum are the common symptoms. Rarely, this can present with acute intestinal obstruction. The classical triad of abdominal pain, sausage shaped palpable mass and passage of red current jelly stools seen in children is rarely seen in adults. Fewer than 20% of cases present acutely with complete bowel obstruction. A palpable abdominal mass is present in only 7% to 42% of cases [12, 13].