Intususcepción colónica por lipomatosis

Introduction: intussusception is quite unusual in adults and usually associates a pathological lesion as the head of it. Lipoma, being the third tumor of the colon has a low incidence. Normally they are solitary although in rare cases, multiple simultaneous can simulate a polyposis. Clinical report: we present a 34-year-old man, with no pathological history, incoming to emergency room due to 5 days long generalized abdominal pain, flatulence and bloody stools. No special exploratory signs. CT scan shows colo-colic invagination without signs of intestinal distress. A non-effective decompressive colonoscopy is performed, which demonstrates a colo-colic invagination with ischemic mucosa and probable pneumatosis located 30 cm from anal verge. We performed segmental laparoscopic colectomy in invaginated transverse colon, and mechanical latero lateral anastomosis. Its opening shows multiple lipomas as the head of invagination, which are confirmed by pathologist. Length of stay was 5 days, and discharged asymptomatic. He was followed-up one month after, asymptomatic. Discussion: lipomas of the gastrointestinal tract are non-epithelial benign tumors. The presence of several simultaneous is rare, and more than four, extremely rare. The exceptionality of this case is that, in addition, lipomatosis becomes the head of intussusception, with few publications found. TC is usually accurate enough, like colonoscopy. They usually do not need treatment. In case of need, endoscopic polypectomy (when they are polypoids) avoids more extensive surgery. The laparoscopic approach in experienced groups allows us to provide the advantages of laparoscopy to a resection that, a priori, should not be oncologic. Introducción: la invaginación intestinal es bastante inusual en adultos y suele asociar una lesión patológica como cabeza de la misma. El lipoma, siendo el tercer tumor del colon, tiene una incidencia baja. Lo habitual es que sean solitarios aunque en raras ocasiones pueden presentarse múltiples simultáneos simulando una poliposis. Caso clínico: presentamos varón de 34 años, sin antecedentes, que acude a Urgencias por dolor abdominal generalizado, flatulencia y deposiciones sanguinolentas de cinco días de evolución. Exploración sin especial interés. TAC muestra invaginación colo-cólica sin signos de sufrimiento intestinal. Se realiza colonoscopia descompresiva no efectiva, que objetiva a 30 cm de margen anal una invaginación colo-cólica con mucosa isquémica y probable neumatosi