Lee Eun Sung, Lee Kang Nyeong, Choi Kyung Soo, Lee Hang Lak, Jun Dae Won, Lee Oh Young, Yoon Byung Chul, Choi Ho Soon
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Clin Endosc. 2013 Jul;46(4):414-7. doi: 10.5946/ce.2013.46.4.414. Epub 2013 Jul 31.
A 73-year-old woman presented with intermittent abdominal pain and weight loss of 15 kg for 2 years. Colonoscopy revealed an erythematous polypoid tumor with a long and wide stalk in the cecum, but with air inflation, it abruptly went away through the ileocecal valve (ICV). An abdominal computed tomography showed a well-demarcated pedunculated subepithelial mass of 2.6×2.7 cm size with fat attenuation in the terminal ileum. It was an intussusceptum of the ileal lipoma through the ICV. This ileal lipoma was causing her symptoms because repeated ileocolic intussusceptions resulted in intermittent intestinal obstructions. In order to avoid surgical sequelae of ileal resection, snare polypectomy using cap-assisted colonoscopy technique was performed within the ileum without complications. The histopathology report confirmed it as a subepithelial lipoma. After endoscopic resection of the ileal lipoma, the patient has been free of symptoms and was restored to the original weight.
一名73岁女性，出现间歇性腹痛，2年内体重减轻15千克。结肠镜检查发现盲肠有一个带长而宽蒂的红斑样息肉样肿瘤，但充气后，它通过回盲瓣（ICV）突然消失。腹部计算机断层扫描显示，在回肠末端有一个边界清晰的带蒂黏膜下肿块，大小为2.6×2.7厘米，呈脂肪衰减。这是一个通过ICV的回肠脂肪瘤套叠。这个回肠脂肪瘤导致了她的症状，因为反复的回结肠套叠导致了间歇性肠梗阻。为避免回肠切除的手术后遗症，使用帽辅助结肠镜技术在回肠内进行圈套息肉切除术，无并发症。组织病理学报告证实其为黏膜下脂肪瘤。回肠脂肪瘤经内镜切除后，患者症状消失，体重恢复至原来水平。
