Kang Bin, Zhang Qingkai, Shang Dong, Ni Qingqiang, Muhammad Faheem, Hou Li, Cui Wenjun
Department of Acute Abdominal Surgery, First Affiliated Hospital, Dalian Medical University, No, 222 Zhongshan Road, Dalian 116011, Liaoning Province, China.
World J Surg Oncol. 2014 May 7;12:143. doi: 10.1186/1477-7819-12-143.
We herein report a case of spontaneous rectal expulsion of an ileal lipoma in a 65-year-old female patient who presented with recurrent attacks of subacute intestinal obstruction. During each episode, the patient developed severe abdominal pain and expelled a fleshy mass from her rectum. The fleshy mass was histopathologically diagnosed as a lipoma comprising fat cells, fibers, and blood vessels. Upon expulsion, the pain disappeared and the intussusception was immediately resolved. Colonoscopic examination revealed a 2.5-cm diameter ulcerated lesion near the ileocecal valve, which was confirmed to be inflammation by pathological examination. A subsequent barium series revealed a normal colonic tract, and the patient remained completely symptom-free for 4 months after the incident. According to the relevant literature and our clinical experience, the treatment method for a lipoma depends on the patient's clinical manifestations and the size of the tumor. However, the various diagnostic and therapeutic modalities currently available continue to be debated; whether an asymptomatic lipoma requires treatment is controversial. When histopathological examination results allow for the exclusion of malignant lesions such as sarcoma, a lipoma can be resected surgically.
我们在此报告一例65岁女性患者,其患有复发性亚急性肠梗阻,出现了回肠脂肪瘤经直肠自发排出的情况。在每次发作期间,患者都会出现严重腹痛,并从直肠排出一个肉质肿物。该肉质肿物经组织病理学诊断为脂肪瘤,由脂肪细胞、纤维和血管组成。排出后,疼痛消失,肠套叠立即解除。结肠镜检查显示在回盲瓣附近有一个直径2.5厘米的溃疡性病变,经病理检查证实为炎症。随后的钡剂造影显示结肠管道正常,事件发生后患者4个月完全无症状。根据相关文献和我们的临床经验,脂肪瘤的治疗方法取决于患者的临床表现和肿瘤大小。然而,目前可用的各种诊断和治疗方式仍存在争议;无症状脂肪瘤是否需要治疗存在争议。当组织病理学检查结果能够排除肉瘤等恶性病变时,脂肪瘤可通过手术切除。