Giant Duodenal Lipoma: a Rare Cause of Vomiting, Anorexia, Unintentional Weight Loss, and Duodenal Intussusception

Gangliocytic paraganglioma leading to duodeno-jejunal intussusception: A case report

The intussusception of the small bowel is rarely encountered in adult patients and is frequently associated with a lead point that is often malignant. In a 69-year-old female patient with an episode of gastrointestinal (GI) bleeding, computed tomography (CT) showed a duodenal-jejunal intussusception caused by an intraluminal mass. Open polypectomy and reduction of intussusception were performed and the diagnosis of gangliocytic paraganglioma was made at pathological evaluation. It would be important to consider neoplasms like gangliocytic paraganglioma in the setting of adult small bowel intussusception.

Submucosal Lipoma Causing Small Bowel Intussusception

Intussusception involves telescoping of one segment of the intestine into an adjacent segment. Although this diagnosis is common in the pediatric population, it is much less common in adults. One of the main reasons it may occur in adults is due to a mass. Intestinal masses can be malignant, such as gastrointestinal stromal tumors, lymphomas, or adenocarcinomas; or they can be benign. One benign lead point in intussusception is a lipoma. A lipoma usually presents on the trunk, neck, or forearm, but can rarely be seen in the gastrointestinal tract. When it presents in the intestine, it can be either asymptomatic or it can be symptomatic and causes abdominal pain, nausea, vomiting, and gastrointestinal bleeding. Furthermore, it may act as a lead point and causes intussusception. We present an adult patient with two rare findings: small bowel obstruction from intussusception caused by a benign intestinal lipoma as its lead point. The patient was promptly taken to the operating room, where the intussuscepted bowel was resected along with the lipoma, and the patient had an uncomplicated recovery. The pathology report confirmed the specimen to be a submucosal lipoma with mature adipose tissue without atypia. Although intussusception and intestinal lipomas are both rare in adults, it is important to be aware of them on the list of differential diagnoses in adult patients with abdominal pain. This is because it can cause a wide array of complications including, ischemia, bowel perforation, sepsis, shock, and peritonitis. The lead point in intussusception has the possibility of being malignant. Careful consideration of these diagnoses with prompt imaging and appropriate intraoperative management is vital for good patient outcomes.

Giant duodenal lipoma: an unusual cause of gastrointestinal bleeding (a case report)

Duodenal lipoma is a rare location of visceral lipomas, most are found incidentally via endoscopy or surgery and usually are asymptomatic. We report the case of a 58-year-old patient with an active bleeding duodenal lipoma. Although endoscopic treatment was scheduled initially, surgical intervention ultimately was indicated due to large size of tumor.