Ileocolic Intussusception of Ileal Lipoma as a Cause of Gastrointestinal Bleeding

Endoscopic video case: lipomas are benign, and usually submucosal, mesenchymal tumors. Gastrointestinal lipomas are located primarily in the right colon, and to a lesser extent, in the small intestine. They are usually asymptomatic, and when they do cause symptoms, they are non-specific ones, such as occlusive problems, bleeding, abdominal pain, nausea or diarrhea. Endoscopic techniques have been developed to treat lipomas in certain cases. Endoscopic submucosal dissection is a technique originally intended for superficial neoplastic lesions, but it has also been used to resect symptomatic lipomas. However, this is a complex technique that is not performed at all centers in our setting, and it has a higher rate of complications, mainly perforation and bleeding. The loop-and-let-go technique consists of placing a disposable loop on the lipoma pedicle, which promotes a slow mechanical resection, thereby reducing the risk of bleeding and perforation. The unroofing technique consists of the spontaneous removal of the lipoma from the exposed mucosa after making an incision in the upper half of the mucosal surface of the submucosal mass.