Ultrasound is usually the first modality to be recruited. However, it is operator-dependent and the presence of distended bowel decreases the ability to demonstrate the site of the obstruction.

Computed tomography is the imaging check details method of choice for diagnosing intussusceptions. A submucosal lipoma can be diagnosed if a smooth well-circumscribed mass of fat density (-50 to -100 Hounsfield Units) is revealed within the lumen of the bowel or intussuscipiens. The sensitivity of CT scan to correctly diagnose intussusceptions has been reported from 71.4%-87.5% while Selleck AZD0530 its specificity in adults has been reported to be 100% as verified by the subsequent surgery [14, 15]. Capsule endoscopy and digital balloon

endoscopy are newer means for diagnosing lipomas and are particularly helpful in cases involving small bowel lipomas [8]. Definitive surgical resection remains the recommended treatment for adult intussusceptions due to the large proportion of structural causes and the relatively high incidence of malignancy; however, the optimal surgical management remains controversial [1, 2, 6, 7, 9]. Some investigators have stated that small bowel intussusceptions should still be reduced only in patients in whom a definitive benign diagnosis has been made preoperatively, or in patients in whom resection may result in short gut syndrome [9]. The dangers of transperitoneal, vascular, and intraluminal seeding after exposing and handling friable and edematous malignant tissues Tanespimycin supplier has led many surgeons to advocate en bloc resection of the lesion. All surgeons agree, though, that reduction should not be attempted if there are signs of irreversible bowel ischemia, inflammation or when malignancy is being suspected [5, 16, 17]. The advantages of intraoperative reduction of the intussusceptions prior to resection, especially when the small bowel is affected, are that it may preserve a considerable length of bowel and thereby prevent development of short-bowel syndrome. Table 1 The characteristics of the reported

cases of adult intussusception induced by a lipoma Case Age Gender Diagnostic modality Tumor location why Size (cm) Reference 1 69 Male US, CS Descending colon 4 J Clin Ultrasound 2 42 Male CS, BE, CT Descending colon 4.5 Am Surg 3 39 Male US, CT Ileum 4 J Korean Med Sci 4 72 Male EGD, US, CT Stomach 10 Dig Surg 5 28 Male CT Jejunum 3 Ann R Coll Surg Engl 6 20 Female CT Ileum 18 Emerg Radiol 7 41 Male CT Ileum ND Australas Radiol 8 44 Female CT, CS, ECS Ileum 5 Abdom Imaging 9 51 Female US, ECS, CT Cecum 10 Rom J Gastroenterol 10 56 Male US, CT Ascending colon 6 J Laparoendosc Adv Surg Tech A 11 50 Male ECS, CS, CT Ascending colon 5 Pathol Int 12 72 Male CT, EGD Stomach 6 Can J Gastroenterol 13 55 Male CT Ileum ND Surg Today 14 63 Female US, CT Ileum 2.