Colo-colic intussusception secondary to colon lipoma: A case report.

INTRODUCTION AND IMPORTANCE: Intestinal intussusception is rare in adults and it is associated with lead points affecting the colon in around 17% of patients. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Indeed, the incidence of intestinal intussusception is much rare when caused by lipomas. CASE PRESENTATION: Our patient is a 29-year-old male, previously healthy and admitted for severe right lower quadrant abdominal pain of 2-day duration. Computed tomography (CT) scan of the abdomen and pelvis showed large mass of fat consistency containing colon structure. CLINICAL DISCUSSION: Urgent laparotomy was opted during which colo-colic intussusception was diagnosed and right hemicolectomy with primary ileocolic anastomosis was performed. Pathology report showed that intussusception was induced by a colon lipoma. Patient had an uneventful hospital stay and was discharged on post-operative day 5. CONCLUSION: Thus we recommend that colo-colic intussusception caused by lipoma be considered in the differential when diagnosing adults with right lower quadrant pain.

Surgical approach for duodenal diverticulum perforation: A case report.

INTRODUCTION: Duodenal Diverticula is not uncommon and it is mostly found in the 2nd part of the duodenum. Despite the fact that it is mostly found incidentally, it can complicate however it rarely complicates by perforation. Treatment is indicated only in complicated cases and it is divided into conservative and surgical arms. PRESENTATION OF CASE: It is a case of 78 years old Lebanese female that was diagnosed intra-operatively with a perforated duodenal diverticulum after presenting with post prandial abdominal pain, distention and pneumoperitoneum on imaging. Our case was consistent with previous reports where the diverticulum occurred in the second part of the duodenum. We opted for primary resection of the diverticulum and over-sewing. Moreover, patient had an uneventful post-operative course and progressed gradually to be discharged on day 10. CONCLUSION: Our case aims to draw attention to a rare complication of duodenal diverticula and to widen the differential diagnosis of pneumoperitoneum thus concluding about the better treatment option. Previous reports show that proper management is still a controversial topic; however surgical approach is indicated in case of systemic signs.