Spaventa-Ibarrola Antonio, Decanini-Terán César, Becerril-Martínez Guillermo, Menéndez-Skertchly Ana Luisa, Golffier-Rosete Claudio
Departamento de Cirugía General y Colorrectal, Centro Médico ABC, Sur 136 número 116, Col. Las Américas, Deleg. Alvaro Obregón, México, D.F., México.
Cir Cir. 2006 Jul-Aug;74(4):279-82.
Lipomas are the most frequent benign tumors of the digestive tract and 50% are localized in the colon. Most are found submucosally and may vary in their incidence, localization, symptoms and pathogenesis, making diagnosis difficult. We undertook this study to learn the different presentations of an ileocecal valve (ICV) lipoma and conduct a review of the literature due to this uncommon location.
We present the case of a 78-year-old female with intermittent small bowel occlusion, abdominal distention and constipation. Colonoscopy showed a submucous tumor at the ICV, CT scan showed a tumor at the ICV with fat density. Laparotomy was performed with primary resection of the lesion by cecotomy, frozen section was reported as nonmalignant so a primary closure without ICV involvement was achieved. Definitive pathology revealed a benign lipoma.
It is important to know the different presentations of these benign tumors because if there is mucosal ulceration they can be mistaken for a malignant lesion and lead to greater resections. Resection is necessary if they are symptomatic or >2 cm.
脂肪瘤是消化道最常见的良性肿瘤，50%位于结肠。大多数脂肪瘤位于黏膜下层，其发病率、位置、症状和发病机制各不相同，这使得诊断困难。我们开展这项研究以了解回盲瓣脂肪瘤的不同表现，并因这种不常见的位置对文献进行综述。
我们报告一例78岁女性患者，有间歇性小肠梗阻、腹胀和便秘症状。结肠镜检查显示回盲瓣处有一黏膜下肿瘤，CT扫描显示回盲瓣处有一密度为脂肪的肿瘤。通过剖腹术进行手术，经盲肠切开术对病变进行了初步切除，冰冻切片报告为非恶性，因此在未累及回盲瓣的情况下实现了一期缝合。最终病理显示为良性脂肪瘤。
了解这些良性肿瘤的不同表现很重要，因为如果有黏膜溃疡，它们可能被误诊为恶性病变并导致更大范围的切除。如果它们有症状或直径>2 cm，则需要进行切除。
