Department of Surgery, Larissa University Hospital, Larissa, Greece.
World J Emerg Surg. 2011 Jun 13;6:19. doi: 10.1186/1749-7922-6-19.
Lipomas are rare, subserosal, usually solitary, pedunculated small lesions appearing mainly in the large intestine with a minimal malignancy potential. They usually run asymptomatic and become symptomatic when they become enlarged or complicated causing intestinal obstruction, perforation, intusucception or massive bleeding. In rare cases they can be self-detached and expulsed via the rectum as fleshy masses. This event mainly occurs in large, pendunculated lipomas which detach from their pedicle. The reason for this event remains in most of cases unclear although in some cases a predisposing factor does exist. Abdominal pain and obstructive ileus may be observed while in many cases bleeding occurs. The expulsed mass sets the diagnosis and in most of the cases all symptoms subside. Diagnosis is rarely established before surgery with the use of barium enema, computed tomography and colonoscopy which additionally provides measures of treatment and diagnosis. In atypical cases though, in cases where the malignancy can not be excluded or in complicated cases, surgery is recommended. Usually the resection of the affected intestinal part is adequate. If during surgery a lipoma is encountered simple lipomatectomy seems also to be adequate.
脂肪瘤是罕见的、位于浆膜下的、通常为单发的、带蒂的小病变，主要出现在大肠，恶性潜能极小。它们通常无症状，但当它们增大或发生并发症导致肠梗阻、穿孔、肠套叠或大量出血时，就会出现症状。在罕见情况下，它们可能自行脱落并通过直肠排出，成为肉质肿块。这种情况主要发生在较大的、带蒂的脂肪瘤上，它们从蒂部脱落。尽管在某些情况下存在诱发因素，但这种情况发生的原因在大多数情况下仍不清楚。可能会出现腹痛和肠梗阻，而在许多情况下则会发生出血。排出的肿块确立了诊断，大多数情况下所有症状都会消退。在手术前很少能通过钡剂灌肠、计算机断层扫描和结肠镜检查明确诊断，这些检查还提供了治疗和诊断的措施。然而，在不典型病例中，如不能排除恶性肿瘤或在复杂病例中，建议手术治疗。通常，切除受影响的肠段即可。如果在手术中遇到脂肪瘤，单纯的脂肪瘤切除术似乎也足够了。
