Kose Emin, Cipe Gokhan, Demirgan Serdar, Oguz Sukru
Department of General Surgery, Büyükcekmece State Hospital, Istanbul 34500, Turkey.
Department of General Surgery, Bezmialem Vakif University School of Medicine, Istanbul 34093, Turkey.
Oncol Lett. 2014 Sep;8(3):1377-1379. doi: 10.3892/ol.2014.2317. Epub 2014 Jul 4.
Colonic lipomas are a rare type of gastrointestinal benign tumor. Those that are <2 cm are generally asymptomatic and do not require any treatment. However, those that are >2 cm may be symptomatic, resulting in abdominal pain, changes in bowel habits, intestinal obstruction and rectal bleeding. A 39-year-old male patient presented with a mass prolapse through the anal canal, which was causing anal pain and rectal bleeding. The patient was admitted to hospital via the emergency services and directed to the Department of General Surgery with the preliminary diagnosis of a rectal prolapse. A pedunculated polyp (size, 10×8×7.5 cm) was detected at the 35th cm of the anal canal. Due to the large size of the polyp, an endoscopic polypectomy could not be performed. Therefore, the prolapsed lipoma was excised externally and the patient was discharged on the first postoperative day on which no complications were experienced. A colonic lipoma must be considered during the differential diagnosis of anorectal diseases, such as hemorrhoids and rectal prolapses. Local excision, hemicolectomy, and segmental and external resection should be considered in addition to an endoscopic polypectomy for the diagnosis and treatment of colonic lipomas.
结肠脂肪瘤是一种罕见的胃肠道良性肿瘤。直径小于2厘米的通常无症状,无需任何治疗。然而,直径大于2厘米的可能有症状,导致腹痛、排便习惯改变、肠梗阻和直肠出血。一名39岁男性患者出现肿物经肛管脱出,引起肛门疼痛和直肠出血。该患者通过急诊入院,初步诊断为直肠脱垂,被转至普通外科。在肛管35厘米处发现一个带蒂息肉(大小为10×8×7.5厘米)。由于息肉体积较大,无法进行内镜下息肉切除术。因此,将脱出的脂肪瘤进行了外部切除,患者术后第一天无并发症发生,随后出院。在鉴别诊断肛肠疾病(如痔疮和直肠脱垂)时,必须考虑结肠脂肪瘤。除了内镜下息肉切除术外,对于结肠脂肪瘤的诊断和治疗,还应考虑局部切除、半结肠切除术以及节段性和外部切除术。