Torsion of a giant antimesenteric lipoma of the sigmoid: a rare cause of acute abdomen

Abstract

Lipomas of the gastrointestinal tract are uncommon benign tumors of mature adipocytes and may occur in any portion along the gut. Depending on location they may have a variety of clinical presentations and even simulate malignant neoplasms. We report a case of a 58-year-old woman who presented with acute pelvic pain. An emergency sonogram detected a hyperechogenic mass in the left adnexal region, with no vascularization on Doppler. A computed tomography confirmed the hypothesis of a fat containing tumor with signals of torsion. The patient underwent laparoscopy which depicted a mass over the antimesenteric side of the sigmoid with signs of ischemia and twisted vascular pedicle. The lesion was resected, and the microscopy confirmed the diagnosis of lipoma. The multidisciplinary team in the emergency room must be aware of these possible complications in order to optimize patient care.

Mesenteric lipoma with small bowel volvulus: A rare cause of upper gastrointestinal obstruction (a case report and literature review)

“…In case of torsion, patient present acute abdomen with onset of pain and imaging may show inflammatory changes, such as edema and fat stranding. Few cases of mesenteric lipomas complicated with torsion are described in the literature [7] . Ultrasound shows a well defined homogenous echogenic mass, and so can distinguish it from a mesenteric cyst.…”