A recently published case report has shed light on an uncommon cause of abdominal pain in adults: small bowel intussusception due to a benign tumor known as a lipoma. As reported by BMJ Journals, while intussusception is a well-known condition in children, its occurrence in adults is rare and often linked to underlying pathology, making this case both a diagnostic challenge and an educational milestone for clinicians.

Understanding Intussusception in Adults

Intussusception occurs when a part of the intestine slides into an adjacent segment, much like the segments of a telescope. This can lead to obstruction, compromised blood supply, and, if left untreated, serious complications. In children, intussusception is typically idiopathic and can often be managed without surgery. In adults, however, it is uncommon and usually signals the presence of a “lead point”—a lesion or abnormality that acts as a trigger for the telescoping effect.

The Case: A Rare Culprit

The patient detailed in the report was a middle-aged adult who presented with persistent abdominal pain and intermittent episodes of nausea. Imaging studies, including a CT scan, revealed the characteristic “target sign” of intussusception in the small intestine. Further investigation identified a well-defined lesion at the lead point, later confirmed during surgery to be a lipoma—a benign tumor made of fatty tissue.

Small bowel lipomas are rare and often asymptomatic, but in this case, the tumor’s size and location caused the bowel to telescope into itself, leading to the patient’s symptoms. Surgical intervention was required to both resolve the intussusception and remove the underlying lipoma. The patient recovered well following the procedure.

Lessons for Clinical Practice

This case underscores several important lessons for healthcare providers. First, while adult intussusception is rare, it should be considered in the differential diagnosis for adults presenting with unexplained abdominal pain, especially if imaging suggests bowel obstruction. Second, the identification of a lead point is essential, as it often points to a pathological cause—sometimes malignant, but occasionally benign, as in this case.

Early recognition and intervention are crucial to prevent complications such as bowel ischemia or perforation. Surgical management remains the gold standard in adult cases, both to relieve the obstruction and to address the underlying cause.

Broader Implications

The report also highlights the value of advanced imaging techniques in diagnosing complex abdominal conditions. CT scans, in particular, can provide rapid, accurate identification of intussusception and its cause, guiding timely surgical decision-making.