Colonic intussusception caused by a sigmoidal lipoma: A case report.

INTRODUCTION: Intussusception is a relatively common condition seen in children. In comparison, adult intussusception is rare and is often secondary to inflammatory diseases, benign or malignant tumors and motility disorders. Being a benign cause, lipomas appear as a particularly rare gastrointestinal tumor. PRESENTATION OF CASE: We present a case of colo-colonic intussusception secondary to a sigmoidal lipoma, in a 40-year-old man. We describe the different aspects of diagnosis and management of this rare complication. DISCUSSION: Adult intussusception is the cause of symptomatic bowel obstruction in 1% of cases and its colo-colonic occurrence represents 17% of all intestinal intussusceptions. The case that we describe is particularly unique because apart from being an example of intussusception in adults, it occurred in the sigmoid colon and was not associated with a malignant lesion. The treatment of intussusception in adults is surgical resection because of the high incidence of underlying malignancy. Colonoscopy is a modality which allows direct visualization of the lipoma. However, intraluminal reduction via colonoscopy is not recommended. CONCLUSION: Colo-colonic intussusception is a very rare complication of lipoma. It is determined that the treatment is surgical due to the risk of malignancy.

Gastric Adenocarcinomas in Central Tunisia: Evolution Specificities through Two Decades and Relation with Helicobacter pylori.

INTRODUCTION: In developed countries, authors have reported variations over time in the seat and histological type of gastric adenocarcinomas, which were explained by Helicobacter pylori infection (HPI) incidence changes. In North-African countries and the Arabic world, epidemiological changes in gastric adenocarcinomas are still unknown. Our study aims to explore and to describe those changes in central Tunisia. MATERIALS AND METHODS: This is a retrospective observational and descriptive study including 876 cases based on the National Central Tunisian Register of Cancers over a period of 21 years. Two groups were formed and compared (group A: 337 patients from 1995 to 2005; group B: 539 patients from 2006 to 2015). RESULTS: HPI decreased from 32.6% in group A to 11.2% in group B (p < 0.05). Signet ring cell carcinomas increased in 2 decades from 14% in group A to 36% in group B (p < 0.05). Proximal cancers were 16.61% in group A and increased to 19.66% in group B (p = 0.3). Total gastrectomy rate was 10.4% in group A versus 23.2% in group B (p < 0.05). CONCLUSION: This study has shown a significant increase of signet ring cell carcinomas with a simultaneous decrease in HPI in the last decade in central Tunisia.

Partial spontaneous anal expulsion of the right colon lipoma: An exceptional diagnostic circumstance.

INTRODUCTION: Lipomas are most common benign tumors of the colon. They are asymptomatic and fortuitously discovered on a morphological examination. Rarely, they cause complications such as acute intussusception. In this article, we reported an exceptional discovery mode of right colon lipoma. CASE PRESENTATION: A 54-year-old woman has consulted for acute abdominal pain relieved by the anus emission of a fat ball that she brought back with her. Abdominal computed tomography scan showed the remaining part of a lipoma developed in her right colon. Laparoscopic right colonic resection was performed. DISCUSSION: Colic lipomas are usually asymptomatic and surgical indication in these cases is debated, but it is indicated whenever complications occur such as acute intestinal intussusception. In this case, discovery mode was not considered as a complication because lipoma evacuation could have been complete. Radiological explorations and colonoscopy could evaluate the lesional state. When surgery is decided, intersecting therapeutic strategy of a short colonic resection guided by a colonization during colonoscopy should be considered. CONCLUSION: The spontaneous expulsion of a colonic lipoma is very rare. Our observation showed that this expulsion may be partial. +The changes that the lipoma undergoes can evoke a malignant cause. a supplement to take care of this eventuality is necessary.