Small Intestinal Lipoma as a Cause of Massive Gastrointestinal Bleeding Identified by Intraoperative Enteroscopy. A Case Report and Review of the Literature

Zografos, Georgios; Tsekouras, Dimitrios; Lagoudianakis, Emmanuel; Karantzikos, Georgios

doi:10.1007/s10620-005-3043-5

Cited by 16 publications

(12 citation statements)

References 8 publications

(23 reference statements)

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“…Indeed, small intestinal tumors are rare, accounting for only 1-2% of all gastrointestinal tract tumors [6]. Lipomas of the small intestine are rare benign tumors with no malignant potential and are most commonly encountered incidentally, since they are usually asymptomatic [18]. In the present case, although the initial examination revealed a fatty, dense mass with clear margins, suggestive of lipoma, we recommended surgical resection because of the symptomatic tumor.…”

Section: Discussionmentioning

confidence: 77%

Adult ileoileal intussusception induced by an ileal lipoma diagnosed preoperatively: report of a case and review of the literature

et al. 2011

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We herein report a case of adult ileoileal intussusception induced by an ileal lipoma. A 68-year-old woman with a history of small intestinal tumors was admitted to our hospital with severe, colicky lower abdominal pain, similar to episodes experienced in the past. A barium meal enema at the initial admission demonstrated a small intestinal tumor in the ileum 30 cm proximal to the ileocecal valve. Abdominal ultrasound sonography and computed tomography showed a sausage-shaped mass presenting as a target sign in the right lower abdomen, suggestive of intussusception. There was also a round mass of fat attenuation representing a lipoma, which was considered the lead point of the intussusception. The patient underwent emergency surgery and partial resection of the ileum, including the ileal tumor, following reduction of the intussusception. The resected specimen contained a round tumor measuring 1.5 × 1.5 × 1.4 cm, which was diagnosed histopathologically as an intestinal lipoma. The patient made a satisfactory recovery and was discharged on postoperative day 10. The clinical characteristics of previously reported lipomas with intussusception are also discussed, including the relationships between the tumor size and symptoms or location.

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Section: Discussionmentioning

confidence: 77%

Adult ileoileal intussusception induced by an ileal lipoma diagnosed preoperatively: report of a case and review of the literature

et al. 2011

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“…Their location and the peak age vary, however approximately 50% were found in the ileum, and the sixth to seventh decades of life were considered to be the most risky period [4,11] . In general, lipomas are defined to originate in the submucosal layer and are usually solitary, with variable sizes ranging from 1 cm to 30 cm [12] . They usually appear as a sessile protrusion into the lumen of the intestine.…”

Section: Discussionmentioning

confidence: 99%

“…Intestinal obstruction is one of the major result due to the occlusion of lumen by a large protruding lesion. Hemorrhage which is an other possible consequence might be based on an ulceration of the overlying mucosa caused by direct pressure from the lipoma or due to intussusception per se [4,12] . Preoperative diagnosis of small intestinal lipomas can be established by means of endoscopic and radiologic evaluation.…”

Section: Discussionmentioning

confidence: 99%

Lipoma within inverted Meckel’s diverticulum as a cause of recurrent partial intestinal obstruction and hemorrhage: A case report and review of literature

Çakmak

Emre²,

Taşçılar³

et al. 2007

WJG

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Moreover, the association of a lipoma within the inverted Meckel's diverticulum as a leading point of bleeding and recurrent episodes of partial intestinal obstruction is such an unusual circumstance that might be considered quite impossible.Meckel's diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, which is reported to occur in 1%-3% of the general population and autopsy series [1,2] . However, the lifetime risk of complication development in patients with Meckel's diverticulum was proposed to be less than 5% in recent investigations [3] . These complications included intestinal obstruction, intussusceptions, inflammation and bleeding.Lipomas are the rare benign tumors of the small intestine with no malignant potential and mostly encountered incidentally during investigation of the gastrointestinal tract for another reason, since they are usually asymptomatic [4] . As small intestinal lipoma is relatively infrequent, it is even a rarer source of gastrointestinal bleeding.We present a case of a 47-year-old man with fatigue, chronic abdominal pain and tarry stool due to an inverted Meckel's diverticulum with a subserosal lipoma. This is a special case that has not appeared in literature over the past 4 decades. Although the incidence of Meckel's diverticulum is high, inversion is a scarsely diagnosed entity and the association of a lipoma within the inverted Meckel's diverticulum as a leading point of lower gastrointestinal hemorrhage without the existence of heterotopic gastric and pancreatic tissues and recurrent partial intestinal obstruction is an exceptional case. CASE REPORTA 47-year-old man was admitted to our clinic with fatigue, recurrent episodes of constipation and abdominal pain. Melena was mentioned on admission. He denied vomiting, fever, or chills. He had had symptoms intermittently for about 4 mo, leading to several hospital visits. Over the previous 2 mo, the episodes of pain became more pronounced with radiation to his back. The patient was not using any specific medication and his medical history did not suggest a major disease. Physical examination revealed a temperature of 37℃, a pulse rate of 90 beats per minute (bpm), a blood pressure of 110/70 mmHg, and a respiration rate of 18 breaths per minute. The CASE REPORT Lipoma within inverted AbstractLipoma within an inverted Meckel's diverticulum presenting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent episodes of partial intestinal obstruction and melena due to a subserosal lipoma located in the base of an inverted Meckel's diverticulum. According to our knowledge, this is the first case of a lipoma within a Meckel's diverticulum giving rise to this clinical scenario without the existence of heterotrophic gastric or pancreatic tissues.

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“…Segmental ileotomy was performed, and a microscopic examination revealed mature fat cells, thus confirming a diagnosis of lipoma (Picture 4). Small intestinal lipomas are rare and an even rarer source of massive obscure gastrointestinal bleeding (1,2). Large lipomas can therefore cause intestinal obstructions as well as gastrointestinal bleeding, which may have been induced by the administration of dual antiplatelet therapy in this case.…”

mentioning

confidence: 76%

Small Intestinal Lipoma Causing Obscure Gastrointestinal Bleeding

Sawada¹,

Yoshida

Adachi³

et al. 2013

Intern. Med.

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A 77-year-old woman with a history of coronary artery disease was admitted to our hospital to undergo an examination for the onset of recurrent hematochezia requiring intermittent transfusions. Four months prior to admission, clopidogrel was administered in addition to aspirin after percutaneous coronary intervention. Esophagogastroduodenoscopy and colonoscopy were not able to identify any responsible lesions. Retrograde single-balloon enteroscopy revealed a submucosal tumor with a shallow ulcer in the distal ileum (Picture 1). Abdominal ultrasound showed a hyperechoic mass in right lower quadrant (Picture 2). Computed to-

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Small Intestinal Lipoma as a Cause of Massive Gastrointestinal Bleeding Identified by Intraoperative Enteroscopy. A Case Report and Review of the Literature

Cited by 16 publications

References 8 publications

Adult ileoileal intussusception induced by an ileal lipoma diagnosed preoperatively: report of a case and review of the literature

Adult ileoileal intussusception induced by an ileal lipoma diagnosed preoperatively: report of a case and review of the literature

Lipoma within inverted Meckel’s diverticulum as a cause of recurrent partial intestinal obstruction and hemorrhage: A case report and review of literature

Small Intestinal Lipoma Causing Obscure Gastrointestinal Bleeding

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