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Paper text:
intussusception is not a rare disease in children , however in adults it accounts for only 1% of bowel obstructions , and 5% of all intussusceptions .
we herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma .
a 33-year - old man was admitted to our hospital with three weeks history of colicky epigastric pain . before admission
the patient had been hospitalized at another hospital , but the cause of the repeated colicky epigastric pain had not been identified .
the patient had no significant past medical history of illnesses nor any hospitalization otherwise . on physical examination , the abdomen was flat and no tumor was palpable .
1 ) . colonoscopy revealed ileocolic intussusception , but no obvious cause was identified ( fig .
barium enema for reduction of the ileocolic intussusception showed a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve ( fig .
reduction of the intussusception under barium enema was succeesful , and the patient underwent laparotomy the next day .
however , recurrent ileocolic intussusception was found , for which a manual reduction and a partial resection of the ileum encompassing the small bowel tumor in the ileum 15 cm proximal to the ileocecal valve was performed .
the resected specimen showed a soft and yellowish - white submucosal tumor with a diameter of 40  25 mm .
histological findings revealed fat cells proliferating in the submucosal layer and confirmed the diagnosis of lipoma of the small bowel .
adult intussusception is rare and usually caused by a tumor acting as the apex of the intussusception .
therefore , such a condition should indicate the possibility of the presence of malignancy in the bowel .
however , it has been reported that 52 - 80% of cases of adult small bowel intussusception are caused by benign entities , such as lipoma , hamartomatous polyp , inflammatory polyp , hyperplastic polyp , meckel 's diverticulum or surgery - related lesions .
because benign tumors of the small bowel are commonly polypoid - shaped , the intussusception usually develops before the tumor has grown to a size sufficient to obstruct the passage of the small intestinal contents .
small intestinal tumors are rare , accounting for 1 - 2% of all gastrointestinal tract tumors .
moreover , preoperative diagnosis is often difficult because of the lack of specific clinical symptoms and difficulty with the examination of the small intestine . computed tomography and ultrasonography of the abdomen
. however , further examinations such as barium enema or endoscopic ultrasonography are useful in cases of difficult diagnosis .
it is accepted that gentle preoperative or operative reduction can be attempted safely to avoid unnecessary operation .
laparoscopic surgery for intussusception is increasing , and successful reduction of intussusception recently has been reported .
although more technically difficult than laparotomy , with an increased risk of perforation and dissemination and metastasis in cases of malignancies or with intestinal dilatation , laparoscopic surgery seems to become a procedure of choice for intussusception caused by benign intestinal tumors in the future .
adult intussusception is rare , accounting for only 5% of all intussusceptions , for which preoperative diagnosis is difficult . 
 we herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma . 
 a 33-year - old man was admitted to our hospital with three weeks history of colicky epigastric pain . 
 computed tomography revealed thickening of the ileal wall suggestive of intussusception . 
 colonoscopy revealed an ileocolic intussusception . 
 barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve . 
 the intussusception was reduced , and the patient underwent partial resection of the ileum encompassing the small bowel tumor . 
 histological findings confirmed the diagnosis of lipoma of the small bowel . 
 the patient made a satisfactory recovery and remains well .