A lipoma of the transverse colon causing intermittent obstruction: a rare cause for surgical intervention.

Lipomas of the digestive tract are rare and most often found incidentally during a colonoscopy, computed tomography (CT) scan, surgery, or autopsy.1–3 Lipomas of the colon were first reported by Bauer in 1757 and are most often located in the ascending colon near the cecum.4 These fatty tumors are rarely greater than 2 cm in size and are rarely symptomatic. The most common presentations of symptomatic patients with lipomas greater than 2 cm in size include abdominal pain, hemorrhage, diarrhea, or constipation.4 Lipomas that grow more than 4 cm in size can lead to obstruction and intussusception requiring surgical or endoscopic resection.3–6 These benign tumors are often difficult to diagnose because of their asymptomatic nature or the intermittent nature of patients' symptoms. On plain radiograph, these lesions may produce a radiolucent area above the region of affected bowel. Barium studies are nondiagnostic unless changes in the lipoma's shape and size are seen via a diagnostic test (the squeeze sign).4 More commonly, definitive diagnosis is made after the lipoma is removed and subjected to histopathologic staining.7 Surgical resection is recommended to alleviate symptoms and to rule out malignancy.7 In this case report, we describe an intussuscepted, transverse colonic lipoma that caused intermittent bowel obstruction.