Rare etiology of occlusive syndrome: intussusception following lipoma. A case report

L’invagination iléo-colique sur tumeur caecale est une pathologie rare chez l’adulte. Les circonstances de découvertes sont très variées. Le diagnostic pré opératoire peut être difficile vu que le tableau clinique évolue le plus souvent selon un mode chronique. Nous rapportons un cas d’invagination iléo-caecale sur tumeur iléocæcale survenue chez une femme de 67 ans qui a été opérée en urgence pour un syndrome occlusif. Les signes cliniques et l’imagerie étaient en faveur d’une invagination intestinale aiguë. Cependant, le diagnostic étiologique a été posé en peropératoire et la laparotomie a révélé une invagination intestinale iléo-cæco-colique sur une tumeur du caecum et que la résection carcinologique avec anastomose immédiate était possible. L’évolution postopératoire a été favorable. Mots-clés : Invagination intestinale, caecum, Lipome.

Invagination Intestinale Aiguë De L’adulte: Aspects Diagnostiqsues, Thérapeutiques Et Étiologiques

Introduction: Acute intussusception is a rare clinical entity in adults where it accounts for only 1-2% of intestinal obstructions. The authors wanted to report cases of acute intussusception in adult patients, their diagnostic aspects, their management, and their etiologies. Patients and Methods: This study is a retrospective study of the medical files of patients of both sexes. They include adults over 15 years of age, operated between January 2010 and December 2014, who were diagnosed with obstruction due to acute intestinal intussusception. Results: Six cases of adult intestinal intussusception were collected. The average age was 26.5 years. The sex ratio was 1 and there were so many men as women. Five out of six patients were unstable on admission. The diagnosis was made preoperative in two cases out of six, 33.3%. Ultrasound revealed a target sign in two cases. The ileo-ileal form was the most frequent (5 cases out of 6) or 83.3%. Also, there were two cases of intestinal necrosis out of six. Intestinal resection was performed in five cases or 83.33%. The cause of intussusception was found in four cases out of six or 66.7%. Here, a tumor was the cause in half of the cases. Immediate surgical follow-up was uncomplicated in all patients. Conclusion: Acute intestinal intussusception of the adult is a very rare condition. The preoperative diagnosis of acute intussusception of the adult remains delicate. The ileo-ileal form is more frequent than the ileo-colic form in adults. Treatment is always surgical in adults.