Laparoscopic Resection of Ileal Lipoma Diagnosed by Multidetector-row Computed Tomography

Ako, Eiji; Morisaki, Tamami; Hasegawa, Tsuyoshi; Hirakawa, Toshiki; Tachimori, Akiko; Nakazawa, Kimitaka; Yamagata, Shigehito; Kanehara, Isao; Nishimura, Shigehiko; Taenaka, Naoyuki

doi:10.1097/sle.0b013e3182002ac4

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…The most common sites of colonic lipomas are the ascending colon and cecum, followed by the transverse colon, descending colon, sigmoid colon, and rectum ( 6 ). The distal ileum is the most common location for small intestine lipomas ( 2 , 3 , 25 , 26 , 33 ). In contrast to these studies, there were many more lipomas in the small intestine than in the colon in our series, with the jejunum being the most common site in both the AI and non-AI groups.…”

Section: Discussionmentioning

confidence: 99%

Role of clinical and multidetector computed tomography (MDCT) features in the prediction of patients with intestinal lipoma developing intussusception

Dong,

Tang,

Zhang

et al. 2024

Quant Imaging Med Surg

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Background Intestinal lipoma is considered the most common benign tumor that causes intussusception. This retrospective case-control study aimed to present the clinical and multidetector computed tomography (MDCT) features between intestinal lipomas with and without intussusception and examine risk factors that predict intussusception caused by intestinal lipomas. Methods We retrospectively analyzed 281 adult patients diagnosed with intestinal lipoma by radiologists using whole-abdominal MDCT between January 2015 and August 2022. Patients were divided into adult intussusception (AI) and non-AI groups based on MDCT images. Univariate logistic regression was performed to identify risk factors for intestinal lipoma-induced intussusception. Results A total of 281 patients with intestinal lipomas were included in the study, with an average age of 68.0±11.3 years, and the male to female ratio was about 1:1.4. Among them, 24 patients developed lipoma-induced intussusception. Patients in the AI group presented with more abdominal pain (70.8% vs . 47.1%, P=0.03), nausea/vomiting (37.5% vs . 14.8%, P=0.009), hematochezia/melena (29.2% vs . 11.3%, P=0.02), and abdominal tenderness (66.7% vs . 24.9%, P<0.001). Lipomas were more common in the small bowel (224/281, 79.7%) than the large bowel (57/281, 20.3%). Lipomas in the AI group showed more heterogeneous hypodensity (41.7% vs . 15.6%, P=0.004), longer length (median, 2.2 vs . 1.2 cm, P<0.001), and larger volume (median, 4.1 vs . 0.6 cm 3 , P<0.001). In the univariate logistic regression, lipoma density [odds ratio (OR) =3.875, 95% confidence interval (CI): 1.609–9.331, P=0.003] and lipoma length (OR =3.216, 95% CI: 1.977–5.231, P<0.001) were risk factors for intestinal lipoma-induced intussusception. Conclusions More patients in the AI group have digestive tract symptoms than those in the non-AI group. Lipoma density and length are risk factors for intussusception in patients with intestinal lipoma. In addition, the common site of intestinal lipoma may have changed from the colon to the small intestine.

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Section: Discussionmentioning

confidence: 99%

Role of clinical and multidetector computed tomography (MDCT) features in the prediction of patients with intestinal lipoma developing intussusception

Dong,

Tang,

Zhang

et al. 2024

Quant Imaging Med Surg

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Resolution of intussusception after spontaneous expulsion of an ileal lipoma per rectum: a case report and literature review

et al. 2014

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We herein report a case of spontaneous rectal expulsion of an ileal lipoma in a 65-year-old female patient who presented with recurrent attacks of subacute intestinal obstruction. During each episode, the patient developed severe abdominal pain and expelled a fleshy mass from her rectum. The fleshy mass was histopathologically diagnosed as a lipoma comprising fat cells, fibers, and blood vessels. Upon expulsion, the pain disappeared and the intussusception was immediately resolved. Colonoscopic examination revealed a 2.5-cm diameter ulcerated lesion near the ileocecal valve, which was confirmed to be inflammation by pathological examination. A subsequent barium series revealed a normal colonic tract, and the patient remained completely symptom-free for 4 months after the incident. According to the relevant literature and our clinical experience, the treatment method for a lipoma depends on the patient’s clinical manifestations and the size of the tumor. However, the various diagnostic and therapeutic modalities currently available continue to be debated; whether an asymptomatic lipoma requires treatment is controversial. When histopathological examination results allow for the exclusion of malignant lesions such as sarcoma, a lipoma can be resected surgically.

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Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report

et al. 2015

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Adult intussusception is rare and usually caused by a tumor acting as the lead point. Therefore, laparotomy should be considered for the treatment. Laparoscopic procedures for use in cases of adult intussusception have been recently reported; however, there is no consensus regarding the safety and efficacy. Here, we describe a successful case of laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma, which was preoperatively suspected. An 87-year-old male presented with progressive abdominal distention and vomiting. Contrast radiography of the small intestine showed an ileal tumor, and magnetic resonance imaging indicated a target-like mass, consistent with an ileal intussusception. The patient was suspected with an intussusception due to an ileal lipoma, and laparoscopic surgery was performed. An approximately 10-cm-long ileal intussusception with a preceding tumor was present, and partial resection of the ileum, including the tumor, was performed. Macroscopic examination of the excised specimen showed a pedunculated tumor measuring 4.0 × 3.5 × 1.9 cm with an uneven surface, yielding a histological diagnosis of lipoma. The patient had an uneventful recovery and was discharged on postoperative day 8. This successful case showed that laparoscopic surgery can be a useful, safe, and efficacious procedure for adult intussusception, even in octogenarians.

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Laparoscopic Resection of Ileal Lipoma Diagnosed by Multidetector-row Computed Tomography

Cited by 4 publications

References 19 publications

Role of clinical and multidetector computed tomography (MDCT) features in the prediction of patients with intestinal lipoma developing intussusception

Role of clinical and multidetector computed tomography (MDCT) features in the prediction of patients with intestinal lipoma developing intussusception

Resolution of intussusception after spontaneous expulsion of an ileal lipoma per rectum: a case report and literature review

Laparoscopic management of an octogenarian adult intussusception caused by an ileal lipoma suspected preoperatively: a case report

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