回盲瓣脂肪瘤伴难治性出血。
Ileocecal valve lipoma with refractory hemorrhage.
作者信息
Dultz Linda A, Ullery Brant W, Sun Huan Huan, Huston Tara L, Eachempati Soumitra R, Barie Philip S, Shou Jian
机构信息
Departments of Surgery and Public Health, Weill Cornell Medical College, New York, New York, USA.
出版信息
JSLS. 2009 Jan-Mar;13(1):80-3.
BACKGROUND
Lipomas are the most common benign mesenchymal tumors of the gastrointestinal tract, with the colon being the most prevalent site. Intestinal lipomas are usually asymptomatic. Tumors >2 cm in diameter may occasionally cause nonspecific symptoms, including change in bowel habits, abdominal pain, or rectal bleeding, but with resection the prognosis is excellent. Herein, we describe the case of an elderly male who presented with painless hematochezia.
METHODS
Both colonoscopy and computed tomography of the abdomen and pelvis confirmed the presence of a mass near the ileocecal valve. Because of continuing bleeding, the patient required laparoscopic-assisted right hemicolectomy to resect the mass.
RESULTS
Both gross and microscopic pathology were consistent with lipoma at the ileocecal valve.
CONCLUSION
Previous cases of ileocecal valve lipomas have been reported in the English literature, with the majority presenting as intussusception or volvulus. We present a rare case of an ulcerated ileocecal valve lipoma presenting as lower gastrointestinal bleeding that was treated successfully with laparoscopic resection.
背景
脂肪瘤是胃肠道最常见的良性间叶组织肿瘤，其中结肠是最常见的发病部位。肠道脂肪瘤通常无症状。直径>2 cm的肿瘤偶尔可引起非特异性症状，包括排便习惯改变、腹痛或直肠出血，但手术切除后预后良好。在此，我们描述一例以无痛性便血就诊的老年男性病例。
方法
结肠镜检查及腹部和盆腔计算机断层扫描均证实回盲瓣附近存在肿物。由于持续出血，患者需要行腹腔镜辅助右半结肠切除术以切除肿物。
结果
大体病理和显微镜病理均符合回盲瓣脂肪瘤。
结论
英文文献中曾报道过回盲瓣脂肪瘤病例，多数表现为肠套叠或肠扭转。我们报告一例罕见的溃疡性回盲瓣脂肪瘤，表现为下消化道出血，经腹腔镜切除成功治疗。
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