Curative endoscopic treatment of intussusception due to a giant colonic lipoma using a wedged balloon and ligation with detachable snares

Endoscopic treatment of intussusception due to small intestine polyps in patients with Peutz-Jeghers Syndrome

Background and study aims  Intussusception caused by intestinal polyps in patients with Peutz-Jeghers syndrome usually requires laparotomy. Patients following successful endoscopic reduction using double-balloon endoscopy (DBE) have been reported. The aim of this study was to evaluate the feasibility of endoscopic treatment of intussusception. Patients and methods  We retrospectively reviewed patients who underwent DBE for intussusception due to small intestine polyps in patients with Peutz-Jeghers syndrome from January 2004 to June 2020. Results  Twenty-seven (antegrade 22, retrograde 5) DBEs were performed in 19 patients with 25 sites of intussusception identified during the study period. If the intussusception remained once the endoscope reached the site, endoscopic reduction of the intussusception was performed as needed (15 sites). Ultimately, endoscopic resections (8 sites) or ischemic polypectomies (16 sites) of the polyp causing the intussusception were completed at 24 sites. Only one site could not be treated endoscopically and was treated surgically. The final per-site and per-patient success rates of endoscopic treatment were 96 % (24/25) and 95 % (18/19) respectively. Two patients developed mild acute pancreatitis and one patient developed intussusception after the procedures, both of which were treated non-operatively. Conclusions  Endoscopic treatment of intussusception is feasible to avoid laparotomy in patients with Peutz-Jeghers syndrome.

Intussusception related to transverse colonic lipoma: a case report and review of the literature

Lipomas are rare and benign colonic soft tissue lesions derived from mature adipocytes. Their poor clinical expression usually leads to a coincidental discovery during procedures like colonoscopy, imagery, surgery or autopsy. Due to their small size, a simple observation would usually be recommended. However, colonic lipomas (CLs) with clinical symptoms or signs including abdominal pain, nausea, vomiting, diarrhea, anaemia or even intussusception would need invasive treatment. It is recommended to perform surgery to treat CLs that are >2 cm. Endoscopic procedures could be an interesting alternative for the future but would still require further investigation. We report the case of a 30-year-old patient with transverse CLs leading to obstruction of the descending colon by intussusception and continue by presenting a review of the current literature.