Colonic intussusception in an adult is usually secondary to a malignant cause. However, the most common benign cause of colonic intussusception in adults are colonic lipomas.

Colonic lipomas are usually solitary submucosal lesions that may be sessile or pedunculated. 90% of these are found in the colonic submucosa while the rest originate from the colonic serosa. They favor the right hemicolon and are more common in women.

On CT scan, they have a typical appearance due to fat attenuation and are often incidentally seen on imaging or endoscopy.

They are normally asymptomatic, unless they are the lead point for intussusception, then they present with abdominal pain. Other presentations may include nausea, vomiting, lower GI bleeding, alternating bowel habit and bowel obstruction.

A variety of treatments have been proposed, including a partial colectomy, segmental resection, local excision or endoscopic resection of small lesions.

Malignant causes for large bowel intussusception include adenocarcinoma, metastasis or lymphoma. Adhesions and motility disorders may also result in intussusception.