Lipoma within Inverted Meckel's Diverticulum: A Case Report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Meckel's diverticulum is the remnant of the vitello-intestinal duct that persists in about 2% of the population. It is the most common congenital anomaly of the gastrointestinal tract in children. While the majority of Meckel's diverticula remain asymptomatic, there is a 4-6% rate of symptomatic complications such as bleeding in children and intestinal obstruction in adults. 4 Tumors within Meckel's diverticula occur infrequently , and the incidence of benign tumors developing within Meckel's diverticula is extremely rare. 1 We present a case of il-eo-ileal intussusception due to a lipoma within a Meckel's di-verticulum in a young adult. A 33-year-old man presented with recurrent episodes of abdominal pain. He had experienced intermittent epigastric pain for about 10 months, which developed into pain of the entire abdomen for 3 months. The abdominal pain was not associated with any other symptoms and resolved spontaneously, so he did not seek medical attention. There was no significant past medical or family history. Laboratory findings on admission were un-remarkable. Abdominal computed tomography revealed slightly dilated loops of small bowel and a hypo-dense, irregularly contoured polypoid mass in the ileum (Fig. 1). Radiological features were suggestive of intussusception. However, there was a difficulty in finding the cause of the ileo-ileal intussusception in this patient. He had no history of previous operations or ma-lignancy and was relatively healthy. During the operation to address the intussusception, a dimple was noted in the antimes-enteric ileal wall, 40 cm proximal to the ileocecal valve. Gentle reduction of the intussusception demonstrated a large polypoid mass attached to a stalk at the corresponding mucosa of the dimpled area. Segmental resection of small bowel was performed. Grossly, the resected specimen showed a large pedunculated mass (6×4×3 cm) with surface ulceration. The stalk portion was connected to adjacent mucosa. On sectioning, the mass was homogenous, soft, and yellow with some white fibrotic tissue in the stalk (Fig. 2). The preliminary gross diagnosis was a sub-mucosal lipoma. Microscopic findings revealed that the mass consisted of mature fat cells with scattered pancreatic acinar and ductal cells in the periphery. The mucosa overlying the mass was gastric type epithelium and showed focal ulceration. The proper muscle was obliterated. The final diagnosis …