Document Detail


Giant submucosal lipoma cause colo-colonic intussusception A case report and review of literature.
MedLine Citation:
PMID:  23110909     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Lipoma of the large intestine is rare, with a reported incidence ranging between 0.2% and 4.4%. We present a case of a giant colonic lipoma causing descending-colonic intussusception.
AIMS: A 54-year-old woman visited our emergency room with sudden onset of intermittent abdominal cramps. She was nauseous and had rectal blood loss for three days. Physical examination showed a tender palpable mass in the left lower abdominal quadrant. Rectal examination showed little blood on the glove. A CT scan demonstrated a clear intussusception of the descending-colonic (Fig. 1). Since the clinical presentation was that of an imminent ileus a laparotomy was performed. The intussusception was found in the descending coloni (Fig. 2), en-bloc resection with left hemicolectomy and was performed with end-to-end anastomosis.
DISCUSSION: Lipomas of the gastrointestinal tract are rare conditions first described by Baurer in 1757. Lipomas in the intestinal tract are still relatively rare, however, being present in only 0.2% of a large autopsy series of 60 000 cases reported in 1955. In 90% of cases, lipoma of the colon are localized at submucous level. Submucosal lipomas are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. Accurate preoperative diagnosis is difficult and lipoma is often mistaken for adenomatous polyp or carcinoma.
CONCLUSION: Differential diagnosis includes malignancy, diverticulosis, adenomatous polyps and previous anastomosis. CT is the examination of choice. Surgical approach remains the treatment of choice for large colon lipoma.
Authors:
Emanuele Grasso; Tommaso Guastella
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annali italiani di chirurgia     Volume:  83     ISSN:  0003-469X     ISO Abbreviation:  Ann Ital Chir     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372343     Medline TA:  Ann Ital Chir     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  559-62     Citation Subset:  IM    
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